In the American Journal of Medical Quality, Suratha Elango and colleagues, including Rinad Beidas and Rachel Werner, studied factors important to combating overuse of broad-spectrum antibiotics in outpatient pediatric practices. Primary care clinics in the Children’s Hospital of Philadelphia network completed surveys and then semi-structured interviews on barriers and facilitators to improving their antibiotic prescribing practices, perceptions and reactions to the initiative, and the climate surrounding its implementation.
Practices with a high willingness to change had greater improvements in antibiotic prescribing. Further, high readiness clinicians described more open communication, active group change processes, and group cohesion as factors for their own success. While, low readiness clinicians described functioning independently, being influenced by external forces, and developing group cohesion through the initiative. The authors conclude that in order to achieve success with antibiotic stewardship initiatives they must be tailored toward different levels of readiness to change and specifically address group dynamics.