학술논문

Social dynamics of a population-level dashboard for antimicrobial stewardship: A qualitative analysis.
Document Type
article
Source
American journal of infection control. 49(7)
Subject
Humans
Anti-Bacterial Agents
Pharmacists
Physicians
Quality Improvement
Antimicrobial Stewardship
Antibiotics
Cognitive support
Decision support
Informatics
Learning health system
Social motivation
Clinical Research
Prevention
Infectious Diseases
Epidemiology
Nursing
Public Health and Health Services
Language
Abstract
ObjectiveTo evaluate antimicrobial stewards' experiences of using a dashboard display integrating local and national antibiotic use data implemented in the U.S. Department of Veterans Affairs (VA). This paper reports early formative evaluation.DesignQualitative interviewing.SettingEight VA hospitals participated with established antimicrobial stewardship (AS) programs participated in the pilot.ParticipantsSix infectious disease physicians and eight clinical pharmacists agreed to be interviewed (n = 14).MethodsA 3-part qualitative interview script was used involving a description of local stewardship activities, a Critical Incident description of dashboard use, and general questions regarding attitudes towards the tool. An inductive open coding approach was used for analysis.ResultsWe found 4 themes showing the complexities of using stewardship tools: (1) Data validity is socially negotiated; (2) Performance feedback motivates and persuades social goals when situated in an empirical distribution; (3) Shared problem awareness is aided by authoritative data; and (4) The AS dashboard encourages connections with local quality improvement culture.ConclusionsSocial dimensions of AS tool use emerged as distinct from, and equally important as decision support provided by the dashboard. Successful stewardship tools should be designed to support both the social and cognitive needs of users.