SPRINT Methodology as a Basis for Developing an Antimicrobial Stewardship Program in a Trauma Surgery Service Line

Author(s):
Candance Jefferson; S. Rob Todd; James Suliburk; Jeremy Ward; M. Andrew Davis; R. Mario Vera; Chad Wilson; Marcus Hoffman; Stephanie Gordy; Bradford Scott

Background:

Antimicrobial stewardship programs can decrease adverse events, optimize antibiotic treatment, reduce antibiotic resistance and decrease cost. However, the process to develop a program remains a challenge due to lack of resources and time. Various dissemination and implementation (D&I) models have been used in literature but have been found to be time and resource intensive. The SPRINT model is a common framework used in the technology industry known for its time efficient gains in productivity. Limited data exist to show its utility in the healthcare setting.  We adopted the SPRINT model to develop and implement an antimicrobial stewardship program within a public level 1 trauma center.

Hypothesis:

SPRINT methodology can be successfully applied in developing an antimicrobial stewardship program at a public level 1 trauma center.

Methods:

A multidisciplinary committee of key stake holders including trauma surgery, surgical subspecialties (Orthopedics, ENT, OMFS, Plastic Surgery), nursing, pharmacy and respiratory care were identified. A SPRINT team captain was designated to guide the team through a preSPRINT preparatory review of the literature, interview of local experts and assessment of current practice. Then at a 1-hour focused meeting we would review the proposal to create a service specific guideline. The next week a second 1-hour SPRINT would occur focusing on rollout and education. At completion, there was a consensus on treatment and D&I of the guideline.

Results:

Five infectious processes were identified in developing guidelines including open fractures, facial fractures, C. difficile, pneumonia and intra-abdominal infections. On average, it required 3 weeks for preSPRINT preparation including contact of specific stakeholders, review of literature and assessment of current practice patterns and fallouts. One SPRINT meeting was held for guideline formalization and a second SPRINT for D&I of the guideline. Immediately following SPRINT, Each guideline was distributed in a hard copy and electronically to a cloud based file system available through care providers’ smart phones.

Conclusions:

The SPRINT process can be adapted for rapid dissemination and implementation of an antimicrobial stewardship program. We identified that it is critical for SPRINTs to be driven by leadership to nudge commitment to the process for effective completion. It was imperative that the SPRINT team captain have the ability to work in a multidisciplinary setting and effectively motivate team members. We were able to create and implement five guidelines in only five weeks each in efforts to optimize patient care.