METHODS: A total of 111 acute care hospitals in Tennessee completed the NHSN Annual Survey in 2015. Based on geographic location, hospitals belong to one of 8 Emergency Management Services (EMS) Regions. We applied CDC’s methodology of mapping specific questions/combination of questions to corresponding ASCE. Data were then analyzed using SAS 9.4 (SAS Institute, Cary, NC), and ArcMap™ 10.3 (ESRI, Redlands, CA).
RESULTS: A total of 31% (N=34) of hospitals self-reported having all seven ASCE and 59% (N=65) reported 5 or more ASCE. Forty-nine percent (N=54) of hospitals reported Leadership, 64% (N=71) reported Accountability, and 84% (N=93) reported Drug Expertise. A total of 21% (N=23) of facilities currently require documentation of indication for antibiotic prescriptions. Only 23% (N=25) provided salaried support for AS activities. Twenty-six percent (N=7) of major teaching hospitals had all seven ASCE, compared to 32% (N=27) of non-teaching hospitals. As the number of beds in hospitals increased, the proportion of hospitals having all seven ASCE also increased: 16% (N=4) of hospitals with 0-50 beds, 33% (N=18) of hospitals with 51 to 200 beds, and 38% (N=12) of hospitals with over 200 beds. The number of hospitals per EMS region varied from 9 to 20. In EMS region 2, 45% of hospitals reported all seven ASCE, whereas in the neighboring EMS region 1, only 10% reported all seven ASCE. All hospitals in EMS region 3 currently require documentation of indication for antibiotic prescriptions, compared to only 5% of hospitals in EMS region 5.
CONCLUSIONS: These data helped us define where there are opportunities for improvement in Tennessee hospitals. The geographic variability in implementation was striking. The results were presented to stakeholders, including the Tennessee Hospital Association (THA), to create awareness and promote action. These data became the basis of five key recommendations from the THA board to Tennessee hospitals created to enhance AS.