The impact of a best practice advisory for shifting to oral medications: A quality improvement project.

Linfield, Rebecca Y; Moskatel, Leon S; Carlton, Sean; Amrollahi, Fatemeh; Epstein, David; Chang, Amy; Svec, David; Chen, Jonathan H et al. · J Hosp Med · 2025

prospective_cohort · Level II

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Abstract

We developed a Best Practice Advisory (BPA) to encourage switching from intravenous (IV) to oral (PO) formulations of antimicrobials with equal efficacy, to decrease costs and IV usage. We conducted a prospective study analyzing our BPA's effect on prescribing practices of antimicrobials in the inpatient setting of Stanford Hospital in Palo Alto, CA, over a 22-month period. Our BPA achieved a 1526/6585 (23.2%) acceptance rate and led to decreased use of IV antimicrobials, with substantial direct cost savings of at least $66,976. Future efforts will focus on expanding our BPA to non-antimicrobials given ongoing IV fluid shortages.

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