Consider how you will establish practice-wide procedures for judicious antibiotic prescribing that include:

• Providing guidelines and tools for clinicians to use in the diagnosis of common pediatric infections that distinguishes between viral and bacterial infections
• Utilizing an effective triage system for respiratory infections
• Creating a practice-wide policy for the judicious use and prescribing of antibiotics that is communicated to patients/families
• Making changes to practice procedures through Plan-Do-Study-Act (PDSA) cycles

PDSA Cycle: Start by testing a process to address 1 or more of the procedures listed above.

Plan

• Plan the process: What is the workflow? Who is involved? What materials (eg, rating scales, brochures) are needed and where will they be stored?

Do

• Pilot the process you have laid out.

Study

• Gather feedback from staff. What worked? What did not work?
• Use the information gathered to help refine and improve your process.

Act

• If needed, redesign your process and test again.
• Implement changes that resulted in success.

Use successive PDSA cycles to refine and improve your process. The value of the PDSA cycle is the continuous search for improvement.

• Once a process is working well, standardize improvements and begin to use them regularly.
• Consider formalizing the process as an office policy/procedure document.
• Choose a different process or procedure and use PDSA cycles to test and refine as above.