• Innovation in Action

May 4, 2021

Antibiotic Stewardship Core Element 1: Leadership Commitment

Book about Antimicrobial stewardship (AMS) and stethoscope.

As part of the Health Quality Innovation Network’s commitment to share best practices to optimize the treatment of infections and antibiotic use, our newsletters will feature a series of articles providing an overview of Antibiotic Stewardship Programs (ASPs). The goal of ASPs is to provide every patient with the right antibiotics, at the right time, at the right dose, and for the right duration – to reduce adverse events and improve patient outcomes. In addition, ASPs also reduce C. difficile rates and antibiotic resistance. The Centers for Disease Control and Prevention (CDC) developed The Core Elements of Hospital Antibiotic Stewardship Programs, which outlines seven key components that have been successful.

Today we will focus on Core Element 1, Leadership Commitment. Hospital leadership plays a critical role in helping the program get the resources needed to accomplish goals. Members of leadership must show a clear commitment to the necessary human, financial and information technology resources needed to be successful.

Read through the examples of leadership commitment below to see if your organization is on the right track.

1 Issue a formal board-approved statement on the importance of the ASP
2 Distribute a newsletter column from the CEO and CMO to the medical staff highlighting the ASP and their commitment to improving antibiotic use
3 Dedicate specific salary support for ASP leaders
4 Include goals, targets and time commitments in the job descriptions of ASP leaders
5 Support funding for remote consultation with antibiotic stewardship experts if local resources are not available
6 Regularly reinforce the hospital’s commitment to antibiotic stewardship
7 Share stories and other resources that highlight how ASPs can improve outcomes
1 Designate a hospital executive to serve as a champion
2 Include ASP outcome measures in the facility’s strategic dashboard
3 Integrate ASP activities into quality improvement and patient safety initiatives
4 Include antibiotic stewardship in ongoing provider education
5 Offer financial incentives for units or departments to improve antibiotic use
6 Ensure support from other areas such as quality improvement staff, lab staff, IT and nurses
1 Ensure that ASP leaders have training in measuring and improving antibiotic use
2 Prioritize funding for IT
3 Support efforts and policies to hold providers accountable for improving antibiotic use
4 Engage patients or patient advocates to include the broader community in establishing accountability


Be aware that your efforts could face barriers such as low support by leadership, low awareness at board or c-suite levels, competing priorities or initiative fatigue. The ASP can be prepared to deal with those challenges using some of the following solution ideas.

  • Direct leaders to statements on the importance of ASPs from groups such as the American Hospital Association, the Institute for Healthcare Improvement and The Leapfrog Group, which are recognized by hospital c-suite leaders
  • Develop the business case to show that ASPs provide high value by improving patient outcomes, the patient experience and reducing adverse effects, which in turn decreases costs and results in cost savings
  • Provide leaders with data, narratives and expert-led presentations on ASP benefits
  • Engage patients to share stories about difficile infections and antibiotic-resistant organisms and their impact on patients and families
  • Emphasize that ASP implementation is a workforce and patient safety issue as well as a patient experience issue
  • Discuss the potential impact on the hospital brand if antibiotic stewardship is not prioritized

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