Structure of Antimicrobial Stewardship Programs in Leading US Hospitals: Findings of a Nationwide Survey
Why this work is in the frame
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Bibliographic record
Abstract
BACKGROUND: To examine antibiotic stewardship program (ASP) structure among high-performing hospitals and determine which components of the 2016 Infectious Diseases Society of America (IDSA)/Society for Hospital Epidemiology of America (SHEA) ASP guidelines are implemented at each site. METHODS: A survey of the highest-ranking hospitals, compiled from the 2015-2016 US News and World Report's Best Hospital Rankings, was conducted from August to December 2016. This corresponded to 138 adult and 62 pediatric unique hospitals. We inquired as to which components of the 2016 IDSA/SHEA ASP guidelines were implemented at each site. Appropriate persons at each hospital were emailed surveys after telephone or email conversations confirmed that they belonged to that hospital's ASP. RESULTS: Overall, 101 of 200 hospitals responded (51%). Of these, 82% (n = 83/101) had an active ASP, and 59% (n = 47/80) were active for more than 5 years. Most report to a committee rather than to an individual (n = 68/80, 85%), do not have their own budget (n = 42/80, 53%), and selectively implement IDSA/SHEA recommendations. Additionally, the majority of ASPs in top hospitals follow aspects of The Joint Commission Standards for Antimicrobial Stewardship, which were released after the survey was administered. CONCLUSIONS: Of leading US hospitals responding to our survey, >80% had an ASP, and most implemented the majority of commitments, interventions, and optimization strategies suggested by IDSA/SHEA. Understanding the structure of ASPs in these hospitals will assist other hospitals in program implementation.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it