Recommendations made and accepted by a telehealth-enabled Antimicrobial Stewardship program implemented at rural veterans affairs medical centers

Taissa A Bej; Amelia L Milner; Alexandria Nguyen; Amanda Vivo; Geneva Wilson; Sara Abdelrahim; Brigid M Wilson; Corinne Kowal; Sunah Song; Keri L Rodriguez; Nicole Beyer; Zachary Michaels; Carla Amundson; Kristina L Bajema; Jason P Burnham; Christopher J Crnich; Dimitri M Drekonja; Lauren Epstein; Tola Ewers; Daniel J Livorsi; Muthu Narayan; Joshua D Nordman; Federico Perez; Christopher D Pfeiffer; Rabeeya Sabzwari; Ahmed M Salti; Danielle Tate; Tammy Walkner; Andrew S Webster; Charlesnika T Evans; Robin L P Jump

doi:10.1017/ice.2026.10443

Back

Recommendations made and accepted by a telehealth-enabled Antimicrobial Stewardship program implemented at rural veterans affairs medical centers

Journal article

Peer reviewed

Recommendations made and accepted by a telehealth-enabled Antimicrobial Stewardship program implemented at rural veterans affairs medical centers

Taissa A Bej, Amelia L Milner, Alexandria Nguyen, Amanda Vivo, Geneva Wilson, Sara Abdelrahim, Brigid M Wilson, Corinne Kowal, Sunah Song, Keri L Rodriguez, …

Infection control and hospital epidemiology

05/04/2026

DOI: 10.1017/ice.2026.10443

PMID: 42076802

View Online

Abstract

To support Antimicrobial Stewardship programs (ASPs) as well as the clinical care of patients with infections, we disseminated and implemented a Videoconference Antimicrobial Stewardship Team (VAST) to connect multidisciplinary teams from rural Veterans Affairs (VA) medical centers with geographically distant ID experts. Here, we describe the clinical syndromes discussed and the response to recommendations made during VAST sessions. Between September 2021 to February 2024, eight ID consultants established VASTs with ten rural VAMCs, holding regularly scheduled videoconference sessions to discuss clinical cases and provide recommendations. Data were collected on patient demographics, clinical syndromes, and recommendations. Acceptance of recommendations within one week of each session was assessed via chart review. Six months after the intervention began, we conducted semi-structured interviews to assess participants' perceptions of VASTs. VASTs reviewed 626 cases involving 527 unique patients. Among 763 clinical syndromes discussed, the most common were infections of the respiratory (29%) or urinary tract (21%). Overall, VASTs made 973 recommendations, of which 71% were accepted. Of 570 recommendations related to antibiotics, 459 (80%) were accepted. Among 403 other recommendations, 235 (58%) were accepted. Interviews with participants indicated the importance of building trust and strong interpersonal relationships. VASTs effectively supported Antimicrobial Stewardship in rural VA medical centers (VAMCs) without local ID expertise. High acceptance rates, particularly for antibiotic-related recommendations, suggest that telehealth-enabled provider-to-provider models enhance stewardship efforts.

Details

Title: Subtitle: Recommendations made and accepted by a telehealth-enabled Antimicrobial Stewardship program implemented at rural veterans affairs medical centers
Creators: Taissa A Bej - Geriatric Research Education and Clinical Center
Amelia L Milner - Geriatric Research Education and Clinical Center
Alexandria Nguyen - Geriatric Research Education and Clinical Center
Amanda Vivo - Edward Hines, Jr. VA Hospital
Geneva Wilson - Edward Hines, Jr. VA Hospital
Sara Abdelrahim - Geriatric Research Education and Clinical Center
Brigid M Wilson - Geriatric Research Education and Clinical Center
Corinne Kowal - Geriatric Research Education and Clinical Center
Sunah Song - Geriatric Research Education and Clinical Center
Keri L Rodriguez - VA Pittsburgh Healthcare System
Nicole Beyer - VA Pittsburgh Healthcare System
Zachary Michaels - VA Pittsburgh Healthcare System
Carla Amundson - Minneapolis VA Health Care System
Kristina L Bajema - Oregon Health & Science University
Jason P Burnham - Washington University in St. Louis
Christopher J Crnich - University of Wisconsin–Madison
Dimitri M Drekonja - University of Minnesota System
Lauren Epstein - Emory University
Tola Ewers - University of Wisconsin–Madison
Daniel J Livorsi - University of Iowa
Muthu Narayan - Minneapolis VA Health Care System
Joshua D Nordman - Washington University in St. Louis
Federico Perez - Geriatric Research Education and Clinical Center
Christopher D Pfeiffer - VA Portland Health Care System
Rabeeya Sabzwari - Edward Hines, Jr. VA Hospital
Ahmed M Salti - VA Portland Health Care System
Danielle Tate - St. Louis Veterans Affairs Medical Center, St. Louis, MO, USA
Tammy Walkner - Iowa City VA Health Care System
Andrew S Webster - Emory University
Charlesnika T Evans - Edward Hines, Jr. VA Hospital
Robin L P Jump - Geriatric Research Education and Clinical Center
Resource Type: Journal article
Publication Details: Infection control and hospital epidemiology
DOI: 10.1017/ice.2026.10443
PMID: 42076802
ISSN: 0899-823X
eISSN: 1559-6834
Publisher: Cambridge University Press
Language: English
Electronic publication date: 05/04/2026
Academic Unit: Infectious Diseases; Internal Medicine
Record Identifier: 9985161443302771

Metrics

1 Record Views

See more details