Journal of Pathology Informatics Journal of Pathology Informatics
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TECHNICAL NOTE
Year : 2018  |  Volume : 9  |  Issue : 1  |  Page : 10

Implementation of a mobile clinical decision support application to augment local antimicrobial stewardship


1 Department of Pharmaceutical Care, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
2 Department of Internal Medicine, Division of Infectious Diseases, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
3 Department of Pharmaceutical Care, University of Iowa Hospitals and Clinics; Department of Pharmacy Practice and Science, University of Iowa College of Pharmacy, Iowa City, IA, USA
4 Department of Internal Medicine, Division of Infectious Diseases, Carver College of Medicine, University of Iowa; Iowa City Veterans Affairs Health Care System, Iowa City, IA, USA
5 Department of Pharmacy Practice and Science, University of Iowa College of Pharmacy; Iowa City Veterans Affairs Health Care System, Iowa City, IA, USA
6 Department of Microbiology and Infectious Diseases, University of Sherbrooke, QC, Canada
7 Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA

Correspondence Address:
Dr. Bradley A Ford
200 Hawkins Drive, Iowa City, IA 52242
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jpi.jpi_77_17

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Background: Medical applications for mobile devices allow clinicians to leverage microbiological data and standardized guidelines to treat patients with infectious diseases. We report the implementation of a mobile clinical decision support (CDS) application to augment local antimicrobial stewardship. Methods: We detail the implementation of our mobile CDS application over 20 months. Application utilization data were collected and evaluated using descriptive statistics to quantify the impact of our implementation. Results: Project initiation focused on engaging key stakeholders, developing a business case, and selecting a mobile platform. The preimplementation phase included content development, creation of a pathway for content approval within the hospital committee structure, engaging clinical leaders, and formatting the first version of the guide. Implementation involved a media campaign, staff education, and integration within the electronic medical record and hospital mobile devices. The postimplementation phase required ongoing quality improvement, revision of outdated content, and repeated staff education. The evaluation phase included a guide utilization analysis, reporting to hospital leadership, and sustainability and innovation planning. The mobile application was downloaded 3056 times and accessed 9259 times during the study period. The companion web viewer was accessed 8214 times. Conclusions: Successful implementation of a customizable mobile CDS tool enabled our team to expand beyond microbiological data to clinical diagnosis, treatment, and antimicrobial stewardship, broadening our influence on antimicrobial prescribing and incorporating utilization data to inspire new quality and safety initiatives. Further studies are needed to assess the impact on antimicrobial utilization, infection control measures, and patient care outcomes.


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