Implementing team based care to improve cervical cancer screening rate in community based resident run clinic

21 Figure 1 Abstracts A22 BMJ Open Quality 2020;9(Suppl 1):A1–A32 on A ril 6, 2021 by gest. P rocted by coright. ht://bm jopeuality.bm jcom / B M J O en Q ual: frst pulished as 10136/bm joq020-IH .22 on 2 D ecem er 220. D ow nladed fom Objectives Our goal was to complete and document an ATO for 90% of eligible patients hospitalized on general pediatric medicine or surgery services within 12 months. Methods A multidisciplinary quality improvement team developed an ATO process and electronic documentation tool. Clinical pharmacists were responsible to initiate and document an ATO for pediatric medicine or surgery patients on or before the 5th calendar day of therapy. Interventions included education of pharmacists and physicians, as well as ATO audit and feedback to the pharmacists. We used statistical process control methods to track monthly rates of ATO completion from October 2017 through April 2019. Results Among 647 eligible antimicrobial courses over the 17month study period, the mean monthly documentation rate increased from 54.6% to 83.5% (p < 0.001) (figure 1). The mean ATO documentation rate increased from 32.8% to 74.2% (p < 0.001) for the pediatric medicine service and from 65.0% to 88.1% for the pediatric surgery service (p = 0.006). Among 302 notes assessed for quality, 35.8% had all the required data fields completed. A tentative antimicrobial stop date was the data element completed least often (49.3%) (tables 1 and 2). Conclusions We successfully implemented a pharmacist-driven ATO, highlighting the opportunity for pharmacists to play an active role in antimicrobial stewardship. Defining treatment duration remains an important antimicrobial stewardship target. 23 INCREASING CAPACITY FOR AUTOLOGOUS STEM CELL TRANSPLANTS BY OUTPATIENT CONDITIONING THERAPY: A QUALITY IMPROVEMENT STUDY Uday Deotare. London Health Sciences Centre, Canada 10.1136/bmjoq-2020-IHI.23 Background Autologous Stem Cell Transplant (ASCT) patients have an inpatient length of stay (LOS) of 21–28 days. In a resource constrained environment, this leads to increasing wait times and limited ability to do transplants. We tried to create additional capacity for transplants at our institution by Abstract 22 Figure 1 Abstract 22 Table 1 Adjusted rates and odds ratios of note documentation by day of antimicrobial initation.22 Table 1 Adjusted rates and odds ratios of note documentation by day of antimicrobial initation. Abstract 22 Table 2 Completion rates of the antimicrobial timeout note data fields. Abstracts22 Table 2 Completion rates of the antimicrobial timeout note data fields. Abstracts BMJ Open Quality 2020;9(Suppl 1):A1–A32 A23 on A ril 6, 2021 by gest. P rocted by coright. ht://bm jopeuality.bm jcom / B M J O en Q ual: frst pulished as 10136/bm joq020-IH .22 on 2 D ecem er 220. D ow nladed fom