Starting Jan. 1, 2020, ambulatory health care organizations accredited by the Joint Commission that regularly prescribe antimicrobial agents will be required to abide by newly established antimicrobial stewardship requirements. The framework from the Joint Commission establishes five elements of performance that address antimicrobial stewardship in these types of settings. The first recommends the identification of an antimicrobial stewardship leader.
Infectious Disease News asked Karen Bewer, RN, CPHQ, CPHRM, director of quality and performance improvement at Advanced Pain Management, a group practice focused on comprehensive pain management in Wisconsin and Minnesota, whether antimicrobial stewardship program (ASP) leaders in ambulatory organizations should expect to be paid more for taking on extra responsibility. Bewer is a member of the Joint Commission’s ambulatory care advisory council.
The settings I am the most familiar with are physician offices and ambulatory surgery centers. The teams are smaller, the stays are very short and there is much more teamwork in a setting like that, with more interdisciplinary communication about immediate issues than I ever saw when I was in a similar role in a hospital system.
Ambulatory surgery centers are most often for-profit entities, as clinics are. Sometimes staffing is a little tighter and time is not as available as you would have in an academic or hospital setting, where there are a lot more patients coming and going and a lot more people.
Everybody takes on projects or takes on extra responsibilities. Someone orders the medications, someone orders the supplies, someone makes sure that the biomedical engineers come in to test the equipment. Someone takes responsibility to champion the quality improvement projects and work with the quality improvement team to constantly improve care. Someone is responsible for infection prevention. Many staff have extra duties beyond direct patient care.
You really would not expect extra compensation for being the ASP leader. It is not a promotion; that would just be your project to lead. You would measure your data; you measure prescribing over time. If the project was not showing results, if the amount prescribed was not reduced, you would make some changes. Your team would look at the results and ask the question: Why are the results not what you expected them to be? You analyze the data, and you start over again.
Taking on antibiotic stewardship may assist in climbing the career ladder — a nurse who is very good at taking on extra responsibilities is going to advance more quickly with the extra experience they gain as they take on more responsibility in the ambulatory surgery center or clinic and are effecting positive change with the projects. Climbing the career ladder leads to higher compensation. But you would not expect to make more money per hour for taking on ASP leadership.
Disclosure: Bewer reports no relevant financial disclosures.