Quality indicators for responsible antibiotic use in the inpatient setting: a systematic review followed by an international multidisciplinary consensus procedure

Background This study was conducted as part of the Driving Reinvestment in Research and Development and Responsible Antibiotic Use (DRIVE-AB) project and aimed to develop generic quality indicators (QIs) for responsible antibiotic use in the inpatient setting. Methods A RAND-modified Delphi method was applied. First, QIs were identified by a systematic review. A complementary search was performed on web sites of relevant organizations. Duplicates were removed and disease and patient-specific QIs were combined into generic indicators. The relevance of these QIs was appraised by a multidisciplinary international stakeholder panel through two questionnaires and an in-between consensus meeting. Results The systematic review retrieved 70 potential generic QIs. The QIs were appraised by 25 international stakeholders with diverse backgrounds (medical community, public health, patients, antibiotic research and development, regulators, governments). Ultimately, 51 QIs were selected in consensus. QIs with the highest relevance score included: (i) an antibiotic plan should be documented in the medical record at the start of the antibiotic treatment; (ii) the results of bacteriological susceptibility testing should be documented in the medical record; (iii) the local guidelines should correspond to the national guidelines but should be adapted based on local resistance patterns; (iv) an antibiotic stewardship programme should be in place at the healthcare facility; and (v) allergy status should be taken into account when antibiotics are prescribed. Conclusions This systematic and stepwise method combining evidence from literature and stakeholder opinion led to multidisciplinary international consensus on generic inpatient QIs that can be used globally to assess the quality of antibiotic use

Owner Relationships - A Parallel Network Force

International audienceA special type of interaction and relationship exists between owners and public companies. Applying the business relationship perspective to owner relationships has some interesting implications. Contemporary theory assumes that the role of the owner is mainly providing financial resources (funding). Taking the business network perspective, the owner's relationships are also important as these influence and shape interaction patterns including business relationships and thus the business network. Prior research has shown that the owner - especially if it is a business unit - can be directly involved in both the choice and development of specific customer and/or supplier relationships. These influences from owners can be much more important for the development of the company in question than providing financial resources. One consequence of applying this relationship view on ownership is that it offers the possibility of discussing public ownership in a similar way as private ownership. © 2017 Emerald Publishing Limited