Journal article
Staffing and workflow of an interactive telehealth Antimicrobial Stewardship program with the Veterans Health Administration
Infection control and hospital epidemiology
05/04/2026
DOI: 10.1017/ice.2026.10452
PMID: 42076801
Abstract
Objective: Describe the workload associated with using telehealth to support Antimicrobial Stewardship efforts at Veterans Affairs Medical Centers (VAMCs) without local infectious diseases (ID) expertise. Design: A mixed-methods process assessment to evaluate workload and workflow associated with Videoconference Antimicrobial Stewardship Teams (VASTs). Setting and Participants: Rural VAMC champions paired with ID consultants at geographically distant VAMCs to form VASTs. Methods: Total workload estimates were based on time that champions and ID consultants allocated to VAST activities. Clinical Procedural Terminology (CPT) codes were used to estimate the workloads for clinical encounters. Role-based process maps were developed to understand variation in implementation by VAMC. Results: The average workload that champions and ID consultants allocated to VAST activities was 6.7% (range 1.0%-20.0%) and 8.4% (range 2.0%-12.5%) full-time equivalents (FTEs), respectively. Clinical encounters completed by ID consultants contributed an average of 1.4% (range < 0.01%-2.5%) FTEs to the workload. The average proportion of FTEs required to sustain VASTs was 13.0% (range 3.0%-31.6%). Process maps showed four phases common to each VAST's workflow: case identification, meeting preparation, team meeting, and documentation. The tasks associated with each phase varied between VASTs. Champions carried out most tasks related to case finding and meeting preparation; the ID consultants completed most documentation tasks. Conclusions: The distribution of tasks within and among the VASTs indicated opportunities to improve workflow efficiency. Investing <12.5% of the FTE allocated to VA Antimicrobial Stewardship programs to support the time of an ID consultant from another VAMC can help rural VAMCs achieve staffing sustainability.
Details
- Title: Subtitle
- Staffing and workflow of an interactive telehealth Antimicrobial Stewardship program with the Veterans Health Administration
- Creators
- Amanda Vivo - Edward Hines, Jr. VA HospitalGeneva M. Wilson - Northwestern UniversityDustin D. French - Edward Hines, Jr. VA HospitalTaissa A. Bej - Geriatric Research Education and Clinical CenterBrigid Wilson - Geriatric Research Education and Clinical CenterCorinne Kowal - Geriatric Research Education and Clinical CenterAmelia Milner - Geriatric Research Education and Clinical CenterCarla Amundson - Minneapolis VA Health Care SystemKristina Bajema - Oregon Health & Science UniversityJason P. Burnham - Washington University in St. LouisChristopher Crnich - University of Wisconsin–MadisonLauren Epstein - Emory UniversityDaniel J. Livorsi - University of IowaMuthu Narayan - Minneapolis VA Health Care SystemChristopher Pfeiffer - VA Portland Health Care SystemRabeeya Sabzwari - Edward Hines, Jr. VA HospitalAhmed Salti - Philadelphia College of Osteopathic MedicineDanielle Tate - St Louis Vet Affairs Med Ctr, St Louis, MO USATammy Walkner - Iowa City VA Health Care SystemAndrew Webster - Emory UniversityRobin Jump - University of PittsburghCharlesnika Evans - Northwestern University
- Resource Type
- Journal article
- Publication Details
- Infection control and hospital epidemiology
- DOI
- 10.1017/ice.2026.10452
- PMID
- 42076801
- ISSN
- 0899-823X
- eISSN
- 1559-6834
- Publisher
- Cambridge Univ Press
- Number of pages
- 6
- Grant note
- TECH-Geriatric Research Education and Clinical Center (GRECC) at the VA Pittsburgh Healthcare System MRA0-001-24W / Research Career Scientist I01 HX003364 / United States (U.S.) Department of Veterans Affairs Health Systems Research Merit Award
- Language
- English
- Electronic publication date
- 05/04/2026
- Academic Unit
- Infectious Diseases; Internal Medicine
- Record Identifier
- 9985161340602771
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