Antimicrobials in hospital – development of advanced ePrescribing tools and analytics (ADAPTA) University Hospital Southampton NHS Foundation Trust

Increasing antimicrobial resistance is a global health challenge. Reporting complete and consistent data about the antimicrobial prescribing is vital for quality improvement interventions to reduce resistance. However, this represents a major challenge for hospitals, particularly those that have not implemented ePrescribing.

This project aimed to find a way to visualise and increase understanding of antimicrobial prescribing while also increasing analytical capability and capacity within UHS NHS Foundation Trust.

This involved developing analytics to enable antimicrobial prescribing to be linked to diagnosis, outcomes and resistance for individual and groups of patients to identify areas for improvement.

Data from the Trust’s ePrescribing database over at least two years were reviewed using software from Triscribe Ltd, and the analytics produced adapted in response to user feedback to effectively support population-level analytics.

The first project output was an antimicrobial ‘ward round viewer’ aimed at consultant microbiologists and pharmacists. This dashboard tool brings together all relevant data on each patient (eg medication history, biochemistry, haematology and microbiology) to allow efficient review on a single screen.

The next output under development is a prioritisation dashboard, which highlights patients most likely to benefit from a microbiological review (such as those with a drug/bug mismatch or worsening signs despite antimicrobial treatment) and those suitable for de-escalation. This intelligent patient selection facilitates time savings and more appropriate utilisation of resources.

The project has already enabled evaluation of the successful impact of a five-day antibiotic course length initiative and identified the presence or absence of prescribing trends in relation to infection control issues.

The next phase will involve analysing trends in resistance patterns and their impact on national targets and antimicrobial shortages, and incorporating Transcribe outputs into more Trust clinical systems and internal improvement projects.

Contact information

For more information about this project, please contact Andy Fox, Deputy Chief Pharmacist, University Hospital Southampton NHS Foundation Trust.