2026 Eastern States Conference

Title 
Advancing antimicrobial stewardship by streamlining pharmacist management of culture results through implementation of a collaborative practice agreement in a community hospital emergency department: post implementation assessment  

Authors 
Dasia Simmons, PharmD 
Benjamin Miles, PharmD, BCPS, BCEMP  
Mandana Eimen, PharmD  
Christopher Keeys, PharmD, BCPS 
Paul Norris, PharmD 

Background/Objective 
To evaluate post-implementation outcomes of a pharmacist-driven antimicrobial stewardship model for post-discharge culture review in the emergency department, where patients are often discharged prior to availability of final microbiology results. At Sibley Memorial Hospital, a collaborative practice agreement supports pharmacist-led review, with prior data demonstrating predominantly no-change interventions alongside a subset of clinically actionable modifications, including correction of drug–bug mismatches and initiation of therapy for previously untreated infections. 

Methods 
A post-implementation assessment will be conducted to further define the scope and nature of pharmacist interventions, characterize their clinical significance, and identify opportunities for improvement. The analysis will evaluate patterns of drug–bug mismatches, assess cases requiring no change to determine appropriateness of therapy versus contamination or colonization, and examine cases requiring new antibiotic initiation to identify factors contributing to lack of initial treatment, including ED readmissions. Additionally, infection-specific trends associated with antibiotic changes will be analyzed, and any variations from the collaborative practice agreement will be documented. 

Conclusion 
This post implementation assessment  is expected to further  characterize the clinical relevance of pharmacist-led interventions,  identify opportunities to optimize antimicrobial stewardship efforts,  improve post-discharge outcomes in the ED setting, and meet regulatory compliance ensuring pharmacist interventions are consistently aligned with the approved collaborative practice agreement in the District of Columbia.