Planned Implementation of an Antimicrobial Stewardship Business Plan Using the Firstline Mobile Application
Authors: Weber Matthew , Miller Matthew , Voyer Kira , Johnson Heather , Bozzella Michael , Biehle Lauren , Czaja Christopher , Parker Sarah 
Published: January 2025

Abstract

Corresponding Author: Sarah K. Parker, MD; Professor, Department of Pediatrics, Section of Infectious Diseases; Children’s Hospital Colorado and University of Colorado School of Medicine; 13123 E 16th Ave, Box B055, Aurora, CO 80045; sarah.parker@childrenscolorado.org; 720-777-8811
Alternate Corresponding Author: Matthew J. Weber, MPH, Department of Pediatrics, Section of Infectious Diseases; Children’s Hospital Colorado and University of Colorado School of Medicine; 13123 E 16th Ave, Box B055, Aurora, CO 80045; matthew.weber@childrenscolorado.org; 720-777-8811
Conflicts of interest/disclosures: The authors have no other conflicts of interest or financial disclosures.
Funding sources: This work was supported by Pfizer Global Medical Grants and Global Bridges at Mayo Clinic [grant number 70956251].

Background
Children’s Hospital Colorado partnered with the Firstline mobile application to remove barriers to accessible antimicrobial stewardship guidance for critical access hospitals and other rural healthcare facilities. Standards for an antimicrobial stewardship program are defined by organizations like The Joint Commission and CDC and are key to forming a sustainable stewardship program. Many rural facilities are unable to establish an antimicrobial stewardship business plan due to lack of guidance or the inability to devote resources to that endeavor. The Children’s Hospital Colorado Firstline mobile application became active on 10 October 2023. As of February 2024, 2,385 users have accessed the Children’s Hospital Colorado Firstline application with 20% of users practicing outside of the Denver metro area which demonstrates initial statewide reach of antimicrobial stewardship guidance. This project seeks to outline dissemination of an antimicrobial stewardship business plan tool using the Firstline mobile application as a vehicle for implementation.

Methods
Development of a business plan in the Firstline mobile application is designed to draw together guidance from external agencies for hospitals seeking to fulfill expected competencies of an antimicrobial stewardship program. The business plan tool is intended to allow facilities to adapt its content to craft realistic goals for their own stewardship programs, and the business plan tool will be accessible withing the broader Firstline mobile application to all active users. The numerous outreach efforts of the Children’s Hospital Colorado antimicrobial stewardship team include emails, podcasts, and presentations directed toward internal and external stakeholders. These include the facilities most at need for specific and actionable guidance for creating an antimicrobial stewardship business plan.

Results
The business plan tool contains focused areas including a) why does a business plan matter, b) how hospitals think about money, c) who is your leadership and what matters to them, d) how much support do you need, e) core plan elements including regulatory requirements, patient safety, calculating cost savings (hard and soft costs), and sustainability. The page will be launched in May of 2024. Business plan uptake will be monitored by the number of users accessing the business plan resource itself within the application, and through an embedded survey. These users will be stratified into groups based on geographic location to determine use in rural facilities.

Conclusion
Ongoing dissemination of the Firstline application throughout Colorado will allow small healthcare facilities to access antimicrobial stewardship guidance and resources for developing a business plan for antimicrobial stewardship programs. Firstline user metrics allow for continued analysis of business plan impact.