A visual analytics antibiogram dashboard as part of a comprehensive approach to perioperative antibiotic administration

Title: A visual analytics antibiogram dashboard as part of a comprehensive approach to perioperativeantibiotic administration Authors: Luis M. Ahumada, MSCS, Allan F. Simpao, MD, Jorge A. Galvez, MD, Mohamed A. Rehman, MD,Jeffrey Gerber, MD, PhD, John Martin, MBA, Beatriz Larru, MD, Kaede Ota, MD, MSc, TeleneMetjian, PharmD, Bimal Desai, MD, MBIa The Children’s Hospital of Philadelphia (CHOP) Data Analytics and Enterprise Reporting Group, Philadelphia,PA; b CHOP Department of Anesthesiology and Critical Care; c CHOP Department of Pediatrics; d CHOPDepartment of Pharmacy Services Introduction: Many hospitals routinely perform antimicrobial susceptibility testing for bacterial pathogens. Theresults are often organized into a summary table, or antibiogram, that clinicians use as a reference guide forantimicrobial resistance patterns. Antibiograms display information that can be used to raise awareness of resistanceproblems, support the use of optimal empiric therapy, and identify opportunities to reduce inappropriate antibioticusage. Most hospitals distribute an institution-specific antibiogram as a static document that is generated fromlaboratory data on an annual basis. Anesthesiologists and surgeons must select and administer perioperative antibiotics either for prophylaxis or to treatan active systemic infection. To assist in this decision-making process, we developed a secure, Web-based,institution-specific, user-friendly visual analytics antibiogram dashboard using electronic health record (EHR) datain near real-time that can be accessed in the operating room setting using the anesthesia information managementsystem computer workstation. Methods: We created a visual analytics antibiogram dashboard using both Structured Query Languge queries of ourEHR database and enterprise visual analytical software to track bacterial pathogens and their antimicrobialsensitivity at CHOP. (Figure 1) The antibiogram dashboard provides a user interface to explore our hospital’slaboratory EHR data in near-real time and facilitates the rapid assessment of susceptibilities and resistances ofmicroorganisms to various antibiotics. Results: A visual analytics antibiogram dashboard specific to our institution was designed and implemented asdescribed in the methods. The dashboard allows the user to display up-to-date, hospital-specific antibioticsensitivity data for a particular organism using a variety of filters, groupers, and drop down menus. Discussion: Pediatric anesthesiologists and surgeons must consider many factors when selecting and administeringperioperative antibiotics. While infectious disease specialists usually guide the antibiotic choices and dosages, thereremains a dearth of information at the time of antibiotic administration in the operating room regarding thesusceptibility of organisms to the chosen antibiotic. We created a visual analytics antibiogram dashboard thatincorporates near-real time laboratory and pharmacy data regarding organism speciation, antibiotic susceptibility,and the cost of antibiotic options. This dashboard will be an integral part of a project to optimize perioperativeantibiotic treatment based on our hospital’s EHR data. References1. Hindler JF, Stelling J. Analysis and presentation of cumulative antibiograms: a new consensus guideline from theClinical and Laboratory Standards Institute. Clin Inf Dis 2007; 44(6):867-73. FiguresFigure 1. Screen shots of the CHOP visual analytics antibiogram.