Pfizer and BSAC Announce a Quality Improvement RFP
Establishing Antimicrobial Stewardship (AMS) Centres of Excellence toImprove Patient Outcomes by Addressing Access Disparities
Competitive Grant Program – using Expert Review PanelI.

BackgroundPfizer Global Medical Grants (GMG) supports the global healthcare community’s independent
initiatives (e.g., research, quality improvement or education) to improve patient outcomes in areasof unmet medical need that are aligned with Pfizer’s medical and/or scientific strategies.
Pfizer’s GMG competitive grant program involves a publicly posted Request for Proposal (RFP) thatprovides detail regarding a specific area of interest, sets timelines for review and approval, and uses anexpert review panel (ERP) to make final grant decisions. Organizations are invited to submit anapplication addressing the specific gaps in practice as outlined in the specific RFP.
The British Society for Antimicrobial Chemotherpay (BSAC) is a learned professional organisation
providing a portfolio of global education on infection related topics and a leading influencer ofresponsible antimicrobial use globally.
The purpose of this RFP is to solicit programs that have identified a resource limitation within theirhealthcare organization that impacts establishment of a holistic and sustainable antimicrobialstewardship (AMS) program. The RFP will support delivery, to successful applicant institutions, of aprogramme of work to support the development of local AMS programs and will culminate withaccreditation of centres and lead to a network of AMS Centres of Excellence across the world that canshare learning within their region.
For all AMS grants, the grant requester (and ultimately the grantee) is responsible for the submissionof requested information, engagement with the AMS accreditation process and implementation ofidentified improvement actions supported by the grant. Pfizer must not and will not be involved in any
aspect of project development, nor the conduct or monitoring of the AMS accreditation process.

II.

Eligibility

Geographic scope

Global, covering resource limited settings within both High-IncomeCountry (HIC) and Low- and Middle-Income country (LMIC) settings

Applicant eligibility
criteria•

Only institutions are eligible to receive grants, not individuals or
medical practice groups.

•Institution would ideally be part of a network of hospitals or
institutions of a healthcare provider or within a region to ensure
potential for dissemination of learnings/best practice and toachieve broadest impact.

•Institution must have identified a resource limitation(s) in theirhealthcare organisation that negatively impact on the ability toestablish a holistic and sustainable AMS progam.

•Institution must have information/data available relating tonational and local structures and processes that demonstrates
their current position with respect to AMS.

•The Lead applicant must have a medical or postdoctoral degree(MD, PhD, or equivalent), an advanced nursing degree (BSN with aMS/PhD or Doctorate of Nursing Practice), or a degree in
Pharmacy, Microbiology or Epidemiology

III.

Requirements

Date RFP Issued•

January 27, 2022

Clinical Area•

Anti-infectives

Specific Area of Interestfor this RFP:•

It is our intent to support submissions that focus on establishing orimproving sustainable and holistic hospital AMS programs inresource-limited health facilities and / or in support ofunderserved populations.

•Multi-disciplinary collaborations are encouraged, and all partners
must have a relevant role.

•There is an interest in receiving responses from institutions withestablished AMS programs as well as those without formal
programs but with some local information and management
support to develop AMS.

•Awardees will receive support via a structured framework of needs
assessment, tailored education program, toolkits of broader,
generic training programs, establishment of multi-disciplinary
team practice, formal evaluations and culminating in anaccreditation process.

•The RFP will support awardees over a period of 24-30 months toincrementally develop/improve local AMS programs and toestablish centres of excellence.

•The RFP goal is to seed the development of a global collaborative
community of AMS practice, through the establishment ofaccredited AMS Centres of Excellence that:o Develops and validates a quality management system (QMS)
approach to AMS best practice.
o Identifies barriers to high quality AMS practice and develops/
implements interventions to overcome these.
o Fosters and shares locally developed and tested approaches toimproving practice using QMS tools such as “plan-do-study-act”(PDSA cycle).
o Develops sustainable AMS programs which can share exemplar
practice to spread learning to other institutions across theirregion.

Target Audience:•Disease Burden
Overview:

Antimicrobial resistance (AMR) is widely recognized as one of thebiggest threats to global health today, with the potential to affectanyone, of any age, in any country. AMR limits the effectiveness ofantimicrobials, reducing the range of susceptible pathogens and theconfidence that treatment will be successful. The review on AMR
published in 2016 highlighted the grave impact on mortality, 10 million
deaths per year by 2050, if action is not taken to address inappropriate
antimicrobial use. 1Institutions providing hospital-based care for patients withinfections that have identified resource limitations and / orunderserved populations, within both Higher Income Countries(HICs) and Lower Middle Income Countries (LMICs).

The World Health Organization published its Global Action Plan on
Antimicrobial Resistance in 2015 and called upon individual countries toset out their ambitions around tackling AMR via National Action Plans(NAPs) which should include elements of AMR surveillance and AMS. Akey focus for the WHO was to support and enable national and local
systems for surveillance of antimicrobial use and resistance tocontribute to AMR data collection systems, including the Global
Antimicrobial Resistance Surveillance System (GLASS). 2
AMS is important to control, contain and mitigate AMR. AMS has been
defined as the coordinated interventions designed to improve andmeasure the appropriate use of antimicrobials by promoting theselection of the optimal antimicrobial drug regimen, dose, duration oftherapy, and route of administration. 3
Patients in resource-limited settings are more likely to be prescribedinappropriate antibiotics to treat their infections. Studies found that
inappropriate use of antibiotics was associated with the following:
culture, gender, educational status, marital status, age, number ofchildren, health insurance and poor health care services. 4
AMR affects all countries, but the burden is disproportionately higher in
low-income and middle-income countries. 1 Factors such as poor hygiene
and sanitation, limited access to adequate healthcare infrastructures,and lack of regulations contribute to AMR and the COVID-19 pandemic
has exacerbated the problem. 5
Patients receiving care in low resource facilities may not have equitable
access to effective and holistic AMS programs. As a result, underserved
populations in high income countries often receive suboptimal carereflective of racial and socioeconomic inequalities negatively impacting
their outcomes and the cost of care. The inequitable access to AMS
programs increases the inappropriate use of anti-infectives, hinders
access to novel anti-infectives, and consequently disproportionately
impacts the burden of AMR:

Recommendations andTarget Metrics:•In England, Asian patients were more likely than White Britishsubjects to have ESBL bacteriuria. 6•

In US, in severe infections (sepsis), the largest determinant of death
was socioeconomic status with black patients 2x compared to whitepatients. 7•

In US, hospitalized Black or Hispanic sepsis patients are 7% more
likely to die than white, while those categorized as "Asian and PacificIslander" or "Other" race are 18% or 21% more likely to die thanwhite patients. 8

Key targets for this RFP are for institutions to:•Engage management support and governance structures toestablish/ optimize functioning of an AMS Team to deliver the
local AMS program.

•Incrementally establish local surveillance data for key pathogens
and antimicrobial use.

•Develop and implement national or local guidelines for empiricaltreatment of common infections in collaboration with clinicalleaders.

•Enable healthcare professionals involved in prescribing,administration and monitoring of antimicrobials to have access toand participate in education and training on AMR and AMS
relevant to their role.

In the longer term it is also envisaged that institutions will:

Characteristics of a
Successful Proposal•

Contribute their local data to the GLASS and national/regional
antimicrobial use reporting systems.

•Disseminate the learning in the country/region to otherinstitutions within their network.

•

As an accredited AMS Centre of Excellence, to provide supportand mentor other institutions within their network/region toestablish/further develop AMS programs.

•A clear overall goal of the submission in terms of your institution’sAMS program.

•Specific reference to the resource limitations faced and/or clear
description of the underserved population that establishment ofrobust antimicrobial stewardship programme will benefit.

•Confirmation of management support for AMS with a description ofassociated governance and reporting structures.

•Details of who will provide leadership of the proposed project andthe specific role of each staff member/ partner in the proposedproject including those of any institutions / organizations /associations that will support and facilitate the execution of theproject.
•A comment on capability of your institution to collect data – i.e.,
what are your options for the collection of baseline data(computerized or manual for example)•Details of any data or gap analyses already collected or undertaken.

•Details of how clinical teams will be engaged in the quality
improvement programme to ultimately support informed
antimicrobial prescribing and participation in education and QIinterventions.

•Target for education and training in terms of number andprofessional staff groups.

•An evaluation plan detailing how you will measure the success ofthe project, in addition to the evaluation that will be provided aspart of the programme.

•Description of how you plan to provide advice and support todevelop capacity for AMS and act as partner mentor for one or more
institutions.

•Supporting statement detailing why you think your institution is
worthy of receiving a project grant with reference to the local
project team available to support the work and the resource
limitations/inequity with respect to patient populations. Also
include what being accredited as an AMS Centre of Excellence would
mean for your institution, its staff, and patients.

Out of Scope of this Call Research projects and/or delivery of interventions which only include
education.

Value of QI grant toinstitution•

Access to AMS subject matter expert advice and support, including
access to a local expert / remuneration for a local expert to assistin data collection.

•Evaluation of current AMS activities, gap analysis and support foraction planning to address gaps.

•Bespoke education for AMS team and clinical staff to support
establishment/further development of the local AMS program.

•Evaluation of impact of project on local AMS activities.

•

Opportunities to share learning within network/region andglobally.

•Potential to submit project outputs to international conferences
and to publish work in peer-reviewed journals.

Estimated Monetary
Value of Pfizer-BSAC
Program for successfulInstitutions:

Key Dates:•Establishment of an accredited AMS Centre of Excellence anddevelopment of local mentors to support other institutions within
network/region.

•Successful institutions will receive a supported program of workthat will include gap analysis, delivery of bespoke training, impact
evaluation programme and accreditation of the institute’s AMS
programme over a three-year period.

•The estimated value of the supported program of work to bedelivered in partnership with successful institutions will beapproximately $75,000 dependent on the size and requirements ofyour institution. This value is delivered through the programme ofwork provided to institutions during the duration of the project.

•Please note that no funds will be transferred directly to theorganizations awarded through this competitive grant program.

•RFP release date: January 27, 2022•

Full Proposal Deadline: April 6, 2022
Please note the deadline is 23:59 Eastern Time (New York, GMT 5).

•

Review of Full Proposals by External Review Panel: May 2022•

Anticipated Full Proposal Notification Date: June 2022*•Grants distributed following execution of fully signed Letter ofAgreement*Processing time may take longer for organizations outside of the U.S

How to Submit:•Anticipated Project Start and End Dates: Projects can begin once
grants are fully contracted, and the project will run for up to 3years.

•Please go to www.cybergrants.com/pfizer/QI and sign in. Firsttime users should click “REGISTER NOW”. [Note: there are individual

portals for each grant application type (e.g., knowledge, LOI, research fullproposal, and QI full proposal). Please be sure to use the URL above.]•Click the “Start A New Quality Improvement Application” button.

•For the question “Competitive Grant?” select Yes•

Select the following Competitive Grant Program Name: 2022 HOS
G: AMS Centres of Excellence (BSAC)•Requirements for submission: Complete all required sections ofthe online application form and upload your Quality Improvement
Project Full Proposal (see Appendix A).

•

If you encounter any technical difficulties with the website, pleaseclick the “Technical Questions” link at the bottom of the page.

IMPORTANT: Be advised applications submitted through the wrong
application type and/or submitted after the due date will not be
reviewed by the committee.

Questions:

Grant Agreements:•

If you have questions regarding this RFP, please direct them inwriting to the Grant Officer, Jessica Romano(Jessica.Romano@pfizer.com), with the subject line 2022 HOS G:AMS Centres of Excellence (BSAC).”•If you have any technical questions about AMS relating to yourapplication please contact Jacqueline Sneddon, BSAC Programmes
Manager (JSneddon@bsac.org.uk)•

If your grant is approved, your institution will be required to enter
into a written grant agreement with Pfizer. Please click here toview the core terms of the agreement.
Pfizer has drafted the terms of these agreements to be balanced
and reasonable and to further the goals of both parties.
Negotiating grant agreements requires significant resources, soplease ensure that your institution (including your legaldepartment) is able and willing to abide by these terms before
proceeding with submission of your application as they will need
to be accepted in their entirety.

•Review and Approval
Process

Mechanism by which
Applicants will beNotified:

••

•
•

A specific grant program RFP uses an expert review panel (ERP) to
make final grant decisions.
The panels are comprised of professionals from the medical
community with advanced degrees and expertise in particularclinical areas, or speciﬁc needs of a geographic region/learnergroup, or expertise in research, continuing professional
development or quality improvement
All applicants will be notified via email by the dates noted above.
Applicants may be asked for additional clarification during thereview period.

References:
1.

The Review on Antimicrobial Resistance: Tackling Drug-resistant Infections Globally, May 2016.
160525_Final paper_with cover.pdf (amr-review.org)

2.

World Health Organisation, Resource materials for in-country development and implementationof national action plans to address antimicrobial resistance September 2021 amr-resource-pack2021.pdf (who.int)
3. National Institute for Health and Care Excellence. Antimicrobial stewardship: systems andprocesses for effective antimicrobial medicine use, August 2015. Overview | Antimicrobial
stewardship: systems and processes for effective antimicrobial medicine use | Guidance | NICE
4. Gebeyehu E, et al., ”Inappropriate Use of Antibiotics and Its Associated Factors among Urban andRural Communities of Bahir Dar City Administration, Northwest Ethiopia,” PLoS One, 2015 Sep
17;10(9):e0138179. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0138179
5. Giorgia Sulis, Sena Sayood & Sumanth Gandra (2021) Antimicrobial resistance in low- and middleincome countries: current status and future directions, Expert Review of Anti-infectiveTherapy, DOI: 10.1080/14787210.2021.1951705
6. Rao GG, et al., ”Key demographic characteristics of patients with bacteriuria due to extended
spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae in a multiethnic community, inNorth West London,” Infect Dis (Lond), 2015;47(10):719-24.
DOI: 10.3109/23744235.2015.1055588
7. Kempker JA, et al., ”Risk Factors for Septicemia Deaths and Disparities in a Longitudinal US
Cohort,” Open Forum Infect Dis, 2018 Nov 15;5(12):ofy305. https://doi.org/10.1093/ofid/ofy305
8. Jones, J. M., Fingar, K. R., Miller, M. A., Coffey, R., Barrett, M., Flottemesch, T., Heslin, K. C., Gray,
D. T. and Moy, E. (2017) Racial Disparities in Sepsis-Related In-Hospital Mortality: Using a Broad
Case Capture Method and Multivariate Controls for Clinical and Hospital Variables, 2004-2013,
Critical Care Medicine, 45(12), e1209-e1217. DOI: 10.1097/CCM.0000000000002699

Appendix A
Quality Improvement Project Full Proposal Requirements
Applications will be accepted via the online portal. Full Proposal documents should be no longer
than 10 pages in length (12-point font and 1-inch margins) excluding Organization Detail andReferences. When uploading your Full Proposal please ensure it addresses the following.

Goals and Objectives

Briefly state the overall goal of the project. Also describe how this goalaligns with the focus of the RFP and the goals of the applicant
organization(s).
List the overall objectives you plan to meet with your project both interms of learning and expected outcomes. Objectives should describe thetarget population as well as the outcomes you expect to achieve as aresult of conducting the project.

Assessment of Needfor the Project

Please include a quantitative baseline data summary, initial metrics (e.g.,quality measures), or a project starting point (please cite data on gap
analyses or relevant patient-level data that informs the stated objectives)in your target area. Describe the source and method used to collect thedata. Describe how the data was analyzed to determine that a gapexisted.
If this data isn’t already available, please comment on capability of yourinstitution to collect data – i.e., what are your options for the collectionof baseline data (computerized or manual for example).

Target Audience

Describe the primary audience(s) targeted for this project e.g. Staff
within institution, specific patient populations. Also indicate whom youbelieve will directly benefit from the project outcomes. Describe theoverall population size as well as the size of your sample population.

Project Design andMethods

The project design and methods are pre-determined and are included asappendix.

Innovation

Describe how this project builds upon existing work, pilot projects, orongoing projects developed either by your institution or otherinstitutions related to this project.

Evaluation andOutcomes

In terms of the metrics used for the needs assessment, describe how youwill determine if the practice gap was addressed for the target group.
Describe how you expect to collect and analyze the data.
Quantify the amount of change expected from this project in terms ofyour target audience.
Describe how the project outcomes will be broadly disseminated.

Anticipated Project
Timeline

Provide an anticipated timeline for your project including feasible project
start date.

Additional Information

If there is any additional information you feel Pfizer should be aware ofconcerning the importance of this project, please summarize here.

Organization Detail

Describe the attributes of the institutions / organizations / associations
that will support and facilitate the execution of the project and theleadership of the proposed project. Articulate the specific role of eachpartner in the proposed project.

Budget Detail

Whilst no funds will be transferred directly to the organizations awarded
through this competitive grant program, you are invited to include detailsof any requests for any additional support that you feel is required inaddition to the supported programme of work and accreditation that isoffered.