Changing Antibiotic Prescribing in a Primary Care Network: The Role of Readiness to Change and Group Dynamics in Success.

TitleChanging Antibiotic Prescribing in a Primary Care Network: The Role of Readiness to Change and Group Dynamics in Success.
Publication TypeJournal Article
Year of Publication2017
AuthorsElango S, Szymczak JE, Bennett IM, Beidas RS, Werner RM
JournalAm J Med Qual
Pagination1062860617716541
Date Published2017 Jul 01
ISSN1555-824X
Abstract

Overuse of broad-spectrum antibiotics in outpatient pediatrics remains a significant issue and there is limited evidence on how to effectively implement outpatient stewardship interventions. This study examines the relationship between readiness to change and modifiable factors affecting success of a primary care network antibiotic stewardship intervention. A survey designed to measure readiness to accept a health care innovation was administered to 209 clinicians. Practices were split in half into "high" versus "low" readiness to change. Semistructured qualitative interviews were conducted with 2 to 3 clinicians from 6 practices in each readiness group. High readiness practices trended toward greater improvements between years (8% to 26% vs 2% to 10% mean improvement). High readiness practice clinicians described more open communication, active group change process, and supportive underlying group cohesion. Low readiness practice clinicians functioned more independently and were influenced more by external forces but were developing group cohesion through the initiative. System-wide interventions should be appropriately tailored to different levels of readiness to change, specifically addressing group dynamics and their differing foci of influence.

DOI10.1177/1062860617716541
Alternate JournalAm J Med Qual
PubMed ID28728423