Leadership in Antimicrobial Stewardship

Go to the profile of Shane Desselle
Mar 01, 2019
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Effective leadership means many things, but among them are the ability to take initiative, accept accountability for one’s actions, and empathize with people in various jobs and positions in an organization. Interdisciplinary care is becoming more common. This refers not only to the care that is provided to each, individual patient but also programs geared to optimize safety outcomes for entire groups of patients. A type of program commonly employed in the hospital and increasingly other types of care settings is antimicrobial stewardship. Antimicrobial stewardship refers to coordinated interventions designed to improve and measure the appropriate use of antimicrobial agents by promoting the selection of the optimal antimicrobial drug regimen including dosing, duration of therapy, and route of administration.1 Antimicrobial stewardship programs are critical in settings where infections, both community and nosocomially acquired, are so common. Many of these infections can result in substantial morbidity, even mortality, in addition to increasing length-of-stay and costs.

The Centers for Disease Control and Prevention (CDC) published a statement indicating that pharmacist leadership was among the seven critical components of an antimicrobial stewardship program.2 Other critical components included commitment from hospital leadership, the appointment of a program leader who is accountable for outcomes, the implementation of at least one recommended action to improve antimicrobial use, and the tracking and reporting of antimicrobial data. While pharmacists might be placed in charge, aka the program leader, of some stewardship services, many times the program leader will be a physician. However, pharmacist leadership is necessary regardless of position, and this leadership requires that they demonstrate but not flaunt clinical knowledge and that they elicit support for their recommendations and help guide the program to success. The pharmacist doing so, whether or not at the moment in a leadership position by title, will be much more likely to ascend to leadership positions in the future.  

Additional information about Leadership and Preventing and Managing Medication Errors: The Pharmacist’s Role can be found in Pharmacy Management: Essentials for All Practice Settings, 4e.If you or your institution subscribes to AccessPharmacy, use or create your MyAccess Profile to sign-in to Pharmacy Management: Essentials for All Practice Settings, 4e. If your institution does not provide access, ask your medical librarian about subscribing.

1Fishman, N. Policy statement on antimicrobial stewardship by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), and the Pediatric Infectious Diseases Society (PIDS). Infect Control Hosp Epidemiol. 2012; 33: 322–327.

2Traynor K. CDC says pharmacist-leaders crucial for antimicrobial stewardship. Am J Health Syst Pharm. 2014;71:689-690.

Go to the profile of Shane Desselle

Shane Desselle

Professor of Social and Behavioral Pharmacy, Touro University California

1 Comments

Go to the profile of Shane Desselle
Shane Desselle 22 days ago

Leadership breeds success in clinical programs.