Most laboratorians would agree that in order for an antibiotic stewardship (ABS) committee to do its job, it's important to have someone from the C-suite at the table. Executive buy-in, after all, can be key to securing adequate funding for an ABS initiative, and ongoing C-suite support may be critical to long-term success.
Still, C-suite participation in itself is no guarantee that an ABS program will receive all the tools it needs to make progress around antibiotics. Here's a look at what committee members can do to convey to the C-suite the value ABS brings.
First of all, suggests Edward Septimus, MD, FIDSA, FACP, FSHEA, clinical professor at Texas A&M College of Medicine, it's important to make sure your ABS committee includes all the right people. Among the players to put on the team: representatives from the laboratory and pharmacy, of course, but also someone from information technology, and at least one or two “physician champions" who understand the clinical value of an ABS program.
When it comes to C-suite representation, Dr. Septimus says, be sure your chief medical officer isn't the only one on the team. “That individual generally doesn't have the power of the dollar," he notes. “I really like to make sure that the chief operating officer or the chief financial officer is engaged as well." With your COO or CFO actively participating in ABS discussions side-by-side with your CMO, when you want to implement a new diagnostic study, for example, you can illustrate the “value added" of that study to all of them, Dr. Septimus says.
Too often, notes Michael Broyles, BSPharm, RPh, PharmD, director of pharmacy and laboratory services at Five Rivers Medical Center in Pocahontas, Arkansas, C-suite committee members fail to look at ABS as something that can benefit the entire organization. “They tend to think in terms of silos," he says, focusing on the laboratory and its budget, for instance, or pharmacy's budget and its implications. “It's very easy for the C-suite to say, 'Okay, your budget is thus, and so you're spending more money than we allocated.'"
The laboratory should make it clear to C-suite members that ABS isn't something that can be separated by department, suggests Dr. Broyles. “The thing that we need to consider, most importantly, is to work together as a team." Show the C-suite how that new initiative will affect “total outcomes for all patients," or how it will lead to savings across the health system. “Make them aware of things that they might not be aware of."
Nam Tran, PhD, MS, MAS, HCLD (ABB), FACB, associate professor of clinical pathology and director of clinical chemistry, special chemistry/toxicology, and point-of- care (POC) testing at UC Davis, agrees that it's important to explain to the C-suite how anything you want to do as a lab will impact your organization as a whole. But don't just tell them how that a new ABS tool is going to work, or how a new initiative will help the bottom line. Instead, Dr. Tran says, use data to make your points. “I feel like data speaks for itself. I could spend hours upon hours talking about how this new biomarker is going to be amazing or this new device [will] be fantastic, but it's just another commercial for them—another division trying to get funding for another toy."
Dr. Tran believes the laboratory has three “powerful strengths" it can apply in its position on the ABS committee: data from clinical trials and other research, the technology required to conduct the necessary tests, and the “know-how" that comes with being experts in the field. Use those strengths to your advantage, he recommends, and in all likelihood the C-suite will offer you its support.
Contributing Lab Leader: Amesh Adalja, MD, FACP
By Sue Barnes, RN, CIC, FAPIC
By Brad Spellberg, John G. Bartlett, David N. Gilbert
By the Centers for Disease Control and Prevention