VA Office of Research and Development
Antimicrobial-resistant and healthcare-associated pathogens are a global health threat. The goals of antimicrobial stewardship are to minimize unnecessary and inappropriate antimicrobial use as a means to combat antimicrobial resistance. The interdisciplinary Videoconference Antimicrobial Stewardship Team (VAST) was initially developed and tested as a telehealth teleconferencing training and mentoring program in 2 rural pilot sites, then was extended to 9 rural sites, using telehealth to connect clinicians at a rural VAMC to a geographically distant infectious disease expert. Qualitative interviews showed that participants valued VAST and it improved patient care. This project will expand the VAST to other VAMCs and assess the VASTs' impact on antimicrobial prescribing. This work will directly increase access to antimicrobial stewardship consultation at rural VA facilities, which are often underserved by infectious disease expertise.
Background: Antimicrobial resistance (AMR) is a current pandemic. Access to ID physicians and pharmacists in VHA is limited and many VHA healthcare systems do not have an ID specialist. This gap in expertise is detrimental, as the presence of ID trained physicians and pharmacists in acute care is associated with improved antimicrobial utilization. Telehealth can facilitate antimicrobial stewardship in VA facilities underserved by ID expertise. The interdisciplinary Videoconference Antimicrobial Stewardship Team (VAST)consists of weekly meetings between an interdisciplinary team at a rural VAMC…
Inclusion Criteria: -VA medical centers without local ID expertise that pair with an ID-expert from another VA medical center Exclusion Criteria: -none
Implementation of VAST in hybrid effectiveness trial. Sites that implement VAST will have outcomes measured before and after implementation of VAST. Implementation outcomes will be measured.