How health systems build capacity for antimicrobial stewardship: eight pillars to success

Background: Antimicrobial stewardship (AMS) is crucial for improving infectious disease outcomes and mitigating antimicrobial resistance. Healthcare systems provide an ideal setting for implementing comprehensive AMS, but face challenges related to scale and complexity. Methods: This report describes Ascension’s system-wide AMS program, a model built upon establishing program structures, standardized processes, and fostering empowerment and partnerships. The program is structured around eight key pillars: system-level governance, market-level support, data-driven decision-making, multidisciplinary collaboration, data tracking and reporting, targeted interventions, empowering frontline teams, and stakeholder partnerships. Results: The system’s AMS program has yielded benefits, including the development and dissemination of standardized guidelines, the support of data-driven decisions through robust analytics and performance dashboards, and the deployment of clinical decision support tools. Capacity building has been enhanced through multidisciplinary collaboration and empowering frontline teams. Data tracking and reporting allow for the monitoring of key metrics. Conclusion: Healthcare systems can build capacity and support sustainability to AMS programs through developing structures, standardized processes, and empowerment to achieve optimal outcomes.