Abstract
Background
Antimicrobial resistance (AMR) caused 1.27 million deaths in 2019 and could reach 10 million annually by 2050.¹ In the UK, 67,000 AMR infections in 2023 led to 2,200 deaths.² Despite recognition of antimicrobial stewardship (AMS), monitoring remains fragmented, retrospective and disconnected from real-time decision-making.³ Building on our research and parliamentary advocacy embedding AMS into UK healthcare, this study addresses the critical policy–practice gap through innovative digital technology, advancing stewardship implementation and improving patient safety outcomes.⁴
Objectives
This study aims to develop and validate a real-time antimicrobial stewardship dashboard that integrates prescribing, microbiology and outcome data. Aligned with the Start Smart, Then Focus framework, it enables proactive decision support and evidence-based quality improvement at the point of care.
Methods
Our evidence-based process synthesised findings from three UK NHS studies (2019–2024). A systematic review of 8,763 articles revealed key monitoring gaps.¹ Retrospective analysis of 640 patient records highlighted prescribing patterns and intervention opportunities.² A survey of 240 healthcare professionals identified barriers to stewardship.³ Dashboard development used a four-phase methodology: gap analysis, user-centred design, Excel-based technical development and evidence-based content aligned with Start Smart, Then Focus. Validation involved technical testing and expert review.
Results
The dashboard employs dual-phase monitoring, capturing empirical and pathogen-directed therapy. The Start Smart module shows that community-acquired pneumonia accounts for 40% of respiratory admissions, with only 47% of reviews completed within 48–72 hours. The Focus module tracks isolates, decision timelines and discharge management. Interactive filters allow hospital-to-ward analysis. Validation confirmed accuracy and clinical approval. Its Excel-based design ensures affordability while detecting inappropriate broad-spectrum use beyond 72 hours and enabling real-time tracking of de-escalation opportunities.
Conclusions
This dashboard advances antimicrobial stewardship research from policy advocacy to practical clinical solutions. It shifts stewardship from retrospective auditing to proactive decision support through ward-level monitoring, making stewardship visible, measurable and actionable. Demonstrated feasibility through accessible digital technology offers a scalable model for healthcare systems worldwide.
Antimicrobial resistance (AMR) caused 1.27 million deaths in 2019 and could reach 10 million annually by 2050.¹ In the UK, 67,000 AMR infections in 2023 led to 2,200 deaths.² Despite recognition of antimicrobial stewardship (AMS), monitoring remains fragmented, retrospective and disconnected from real-time decision-making.³ Building on our research and parliamentary advocacy embedding AMS into UK healthcare, this study addresses the critical policy–practice gap through innovative digital technology, advancing stewardship implementation and improving patient safety outcomes.⁴
Objectives
This study aims to develop and validate a real-time antimicrobial stewardship dashboard that integrates prescribing, microbiology and outcome data. Aligned with the Start Smart, Then Focus framework, it enables proactive decision support and evidence-based quality improvement at the point of care.
Methods
Our evidence-based process synthesised findings from three UK NHS studies (2019–2024). A systematic review of 8,763 articles revealed key monitoring gaps.¹ Retrospective analysis of 640 patient records highlighted prescribing patterns and intervention opportunities.² A survey of 240 healthcare professionals identified barriers to stewardship.³ Dashboard development used a four-phase methodology: gap analysis, user-centred design, Excel-based technical development and evidence-based content aligned with Start Smart, Then Focus. Validation involved technical testing and expert review.
Results
The dashboard employs dual-phase monitoring, capturing empirical and pathogen-directed therapy. The Start Smart module shows that community-acquired pneumonia accounts for 40% of respiratory admissions, with only 47% of reviews completed within 48–72 hours. The Focus module tracks isolates, decision timelines and discharge management. Interactive filters allow hospital-to-ward analysis. Validation confirmed accuracy and clinical approval. Its Excel-based design ensures affordability while detecting inappropriate broad-spectrum use beyond 72 hours and enabling real-time tracking of de-escalation opportunities.
Conclusions
This dashboard advances antimicrobial stewardship research from policy advocacy to practical clinical solutions. It shifts stewardship from retrospective auditing to proactive decision support through ward-level monitoring, making stewardship visible, measurable and actionable. Demonstrated feasibility through accessible digital technology offers a scalable model for healthcare systems worldwide.
| Original language | English |
|---|---|
| DOIs | |
| Publication status | Published - 4 Dec 2024 |
| Event | BSAC 2025 Winter Conference - London, United Kingdom Duration: 28 Oct 2025 → 29 Oct 2025 |
Conference
| Conference | BSAC 2025 Winter Conference |
|---|---|
| Country/Territory | United Kingdom |
| City | London |
| Period | 28/10/25 → 29/10/25 |
Keywords
- Antimicrobial stewardship
- antimicrobial stewardship (AMS)
- antimicrobial stewardship (ASP) intervention
- Antimicrobial stewardship programmes
- Antimicrobial stewardship programs
- antimicrobial resistance
- Antimicrobial Resistance
- Antimicrobial resistance (AMR)
- Antimicrobial Resistance (AMR)
- Digital health
- Digital health innovation
- Digital health technology
- Digital health tools
- Real-time dashboard
- Start Smart Then Focus
- Policy implementation
- quality improvement
- QUALITY IMPROVEMENT
- Quality improvement report
- Quality Improvement Initiatives