Impact of integrating objectives and key results into an antimicrobial stewardship program: A retrospective analysis

Background: Objectives and key results (OKRs), a popular management tool in enterprises, have rarely been explored in healthcare. Objectives: This study assessed the impact of OKRs on an antimicrobial stewardship program (ASP) in a large tertiary hospital. Methods: A retrospective analysis was conducted before and after the implementation of OKRs in ASP (the pre-study period was from March to December 2018 and the post-study period was from March to December 2019) on the number of deaths directly caused by infections, the intensity of antimicrobial use and the incidence of bacterial resistance. Results: A total of 259,143 hospitalized patients were included in the study (130,956 before and 128,187 after). The results showed that after the implementation of OKRs in ASP, the antibiotic use density (AUD) decreased by 4.24 DDDs/100 person-days, with a statistically significant difference (p<0.017), while there was no statistical difference in the number of deaths directly caused by infections and the incidence of bacterial resistance. Further analysis revealed that the rate of antimicrobial use among hospitalized patients decreased by 1.87%, the average length of hospital stay was shortened by 0.61 days and the per capita cost of antimicrobial drugs decreased by 48 yuan, all with statistical significance (P<0.01). Conclusion: OKRs, as a simple and practical management tool, have proven highly effective for ASP management and should be widely promoted in the medical field.