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A healthcare worker and patient-informed approach to oral antibiotic decision making during the hospital-to-home transition

Published online by Cambridge University Press:  21 January 2021

Sima L. Sharara
Affiliation:
Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
Alicia I. Arbaje
Affiliation:
Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, Maryland Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
Sara E. Cosgrove
Affiliation:
Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, Maryland
Ayse P. Gurses
Affiliation:
Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, Maryland Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland Whiting School of Engineering, Johns Hopkins University, Baltimore, Maryland
Kathryn Dzintars
Affiliation:
Department of Pharmacy, Johns Hopkins Hospital, Baltimore, Maryland
Nicholas Ladikos
Affiliation:
Department of Pharmacy, Suburban Hospital, Bethesda, Maryland Hospital Epidemiology and Antimicrobial Stewardship, Suburban Hospital, Bethesda, Maryland
S. Sonia Qasba
Affiliation:
Hospital Epidemiology and Antimicrobial Stewardship, Suburban Hospital, Bethesda, Maryland Suburban Hospitalist Group, Johns Hopkins Community Physicians, Bethesda, Maryland Pediatric Emergency Department, Bethesda Emergency Associates, Suburban Hospital, Bethesda, Maryland
Sara C. Keller*
Affiliation:
Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, Maryland
*
Author for correspondence: Sara Keller, E-mail: skeller9@jhmi.edu

Abstract

In a qualitative study of healthcare workers and patients discharged on oral antibiotics, we identified 5 barriers to antibiotic decision making at hospital discharge: clinician perceptions of patient expectations, diagnostic uncertainty, attending physician–led versus multidisciplinary team culture, not accounting for total antibiotic duration, and need for discharge prior to complete data.

Type
Concise Communication
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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