A National Action Plan for Antimicrobial Stewardship (AMS)
HealthCareCAN continues to play a leadership role in promoting Antimicrobial Stewardship (AMS) programming and advocating for increased resources to move the needle on AMS in Canada. HealthCareCAN participated in a host of advocacy meetings with Ministers, senior civil servants, and Canada’s Chief Public Health Officer advocating for a focus on stewardship as part of a pan-Canadian approach to mitigating antimicrobial resistance. We also partnered with professional organizations and civil society to marshal resources and seed the soil for an ambitious AMS agenda in the years to come. We are hopeful that our efforts will be borne out with the release of the pan-Canadian Action Plan on Antimicrobial Resistance, which is currently slated for release in Fall 2019.
Click the button below to learn about leading practices in tackling antimicrobial resistance taking place at our member organizations.
Antimicrobial Resistance Fighters campaign
As President and CEO of HealthCareCAN, I advocate to make antimicrobial stewardship a priority for our political leaders and across the continuum of care. Of the many threats we face in healthcare, antimicrobial resistance is one of the most pressing and deadliest concerns. Our leaders need to recognize this and act accordingly by making sure patients get the right drug, at the right time, at the right dose and only when necessary. We have inherited an extraordinary gift from the antimicrobial pioneers of past decade —it is time we start treating antimicrobials like the precious resources that they are. Because all of us need to be resistance fighters.
Putting the Pieces Together: A National Action Plan on Antimicrobial Stewardship
While Canada was once regarded as a global leader in recognizing and responding to the threat of antibiotic resistance, progress has lagged in recent years. HealthCareCAN and the National Collaborating Centre for Infectious Diseases collaborated together to provide policy-makers a 10 point roadmap for improving antimicrobial stewardship (AMS) in Canada, which builds on and is integrated with a number of key antimicrobial stewardship initiatives taking place in Canada and internationally.
Our 10-point roadmap for improving AMS in Canada
Convene and Fund a National Network to Coordinate Stewardship: “AMS Canada”
Progress in AMS has been a challenge because the actions required fall under many jurisdictions, disciplines and sectors. There is a clear need for leadership and coordinated action to address antimicrobial resistance, and to facilitate the scale-up and spread of leading practices across the country.
Nominate Executive Leads on AMS at the Federal/Provincial/Territorial Levels for Strategic Planning and Implementation
Improved coordination across federal/provincial/territorial health systems could greatly improve progress to address antimicrobial resistance and improve antimicrobial stewardship. National interventions in hospital, long-term care and community-based care settings are possible and achievable.
Enhance Accreditation for AMS
Accreditation Canada is a major driver of stewardship in Canadian healthcare facilities. In 2013, Accreditation Canada began assessing a Required Organizational Practice (ROP) on AMS, establishing AMS as an accreditation requirement. These actions have provided healthcare institutions delivering acute care with a powerful incentive to invest in stewardship.
Support and Scale Up Core Operations in Hospital-Based AMS
Accreditation Canada’s stewardship ROP has created a powerful incentive for hospitals to invest in AMS programming. To complement the ROP, funding can be provided directly to AMS programs to help support hospitals as they develop their AMS programs. The combination of these two strategies will be particularly effective.
Enhance Awareness of AMR and AMS among Prescribers and the Public
Effective engagement often begins with an improvement in the public’s health literacy, and actions on this front should take particular note of groups that are not easily reached. To facilitate that engagement, both community prescribers and the public must be educated about AMR and AMS for community-based AMS programming to change the culture of antimicrobial use.
Establish an AMS Research and Development Fund
To deploy effective AMS programming, Canada must invest in a dedicated research agenda for AMS. To take action on the gaps in evidence at a national level, Canada needs a National AMS Research and Development Fund that will support these and other research priorities. The Fund will also be leveraged to support the scale, spread, and evaluation of stewardship programs in hospitals, as well as community and long-term care.
Develop and Support Core Datasets in AMU Surveillance
The Canadian Antimicrobial Resistance Surveillance System (CARSS) of the Public Health Agency of Canada provides an integrated, national picture of antimicrobial use and resistance in Canada based on available surveillance data from its nine different AMR/AMU surveillance systems. Although the launch of CARSS in 2015 has helped to improve national surveillance, gaps remain.
Incent Community Prescribers Using Audit and Feedback Mechanisms
Under the proposed national electronic prescription monitoring system discussed in Action 7, it may soon be possible to assess the antimicrobial prescribing habits of individual clinicians. With AMU data at this level of specificity, it will be possible to build audit and feedback mechanisms for community care using incentive and regulatory programs.
Develop National Guidelines for Antimicrobial Prescribing and a Mechanism to Promote Adoption
Canada currently does not have national-level guidelines for antimicrobial prescribing. In the absence of national guidelines, clinicians rely on a combination of clinical judgement and consideration of regional or discipline-specific guidelines and standards on antimicrobial prescribing.
Develop a Network of Centres of Excellence in Knowledge Mobilization (NCE-KM) for AMS
Currently there is no national centre for dissemination of evidence and other knowledge related to AMS in Canada. To bridge this gap, AMS Canada will develop a Network of Centres of Excellence on AMS. The Network of Centres of Excellence Initiative in Knowledge Mobilization (NCE-KM) is a partnership between Industry Canada and Health Canada that supports knowledge mobilization collaborations between academia, industry, government and not-for-profit organizations across sectors and disciplines.
AMS Canada and the National AMS Action Plan
Learn about recent developments in the area of antimicrobial stewardship in Canada, and find out how antimicrobial use and appropriateness is being measured in Canada, what gaps which exist in our measurements, and what we can learn from other countries.