Standardized Antimicrobial Stewardship

Best Possible Prescribing of Antibiotics

Bluebird optimizes antimicrobial effectiveness while minimizing the potential for development of drug-resistance and adverse effects. This is accomplished by ePrescribing (described below) and a prospective antibiotic audit with point-of-care interventions, and tight feedback to prescribers. The latter actively educates prescribers of antimicrobials and thereby improves long term antimicrobial prescribing. Bluebird enables selective reporting of susceptibility testing consistent with a hospital's antimicrobial treatment guidelines (even if the labs servicing that hospital lack that capability). Bluebird's individual patient electronic medical record is linked with electronic prescribing and an antimicrobial management system.

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Bluebird is multidisciplinary by design. Ward nurses, ward managers, ward clerks, attending doctors, infectious disease professionals (nurses and physicians), clinical microbiologists and pharmacists all have specific Bluebird log ins. The success of IC and AMS programs depends on the explicit support of the hospital administration and the appropriate allocation of adequate resources which is measured and managed by Bluebird. Bluebird's design is aimed at eliciting the cooperation and engagement of prescribers rather than policing them and undermining the potential for co-operation.


ePrescibing incorporates clinical decision support tools, the hospital formulary (including antibiotic restrictions ... with online approval) and the implementation of local clinical guidelines. Individual patient risks factors are displayed to aid the choice of the best possible antibiotic. There is even a prompt to remember source control. The reason for the prescription (indication), the route (with prompts if it seems unnecessary to prescribe the antibiotic intravenously) as well as expected duration are required. Prompts to ensure that specimens were collected are integrated. Tools to measure compliance with the approval process are available and we recommend they are used to audit this process on a regular basis.

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Identify Cases Requiring Review

Bluebird's rules engine directs the IDPharm and IDPhysician to where their talents are most required and will do the most good. These rules are set for each hospital and depend on available resources. Both workload and resources are measured and paired during on-boarding.


Bluebird's AMS Dashboard groups all relevant information needed to assess and audit individual antimicrobial prescriptions. This dashboard focuses AMS resources on target antimicrobials where interventions are able to do the most good.

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Systematic Standardized Antimicrobial Audit

Bluebird provides a systematic approach to optimising the use of antimicrobials. Target antibiotics that require active management by either IDPharm or IDPhysician (or both, depending on hospital resources) are objectively identified and become a required task on a worklist. This enables more effective targeting of interventions. How that work is completed, is standardized, to allow for objective measurement. These reports are regularly evaluated by management to ensure that available resources are being optimised in each hospital. Importantly, Bluebird standardizes an Initial, and, Time Out audit for target antimicrobials as well as a Surgical Prophylaxis Audit, and, by standardizing the audit process, it is possible to compare metrics, nationally. Bluebird reduces inappropriate antimicrobial use, improves patient outcomes and reduces adverse consequences of antimicrobial use (including antimicrobial resistance, toxicity and unnecessary costs).

Feedback to Prescribing Doctors

Bluebird's prospective antimicrobial audit includes a process for stewards to make constructive recommendations to the prescriber regarding antibiotic modification, and, a follow up process to measure the uptake of those recommendations. Antimicrobial guidance, should be seen as a resource to guide prescribing doctors, rather than an attempt to police them.

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Bluebird provides more than 50 AMS reports. These include, in depth, measurement of process and outcome indicators, and, perhaps uniquely, Bluebird provides tools to measure the quality of antimicrobial prescribing. Reports are unit or ward-specific. Bluebird automatically produces annual, facility-specific, antibiograms, stratified by both specimen and location. Process measures are used to target, and evaluate, initiatives to improve prescribing.

Let us simplify your Fight Against Antibiotic Resistance



Intelligent Medical Systems (Pty) Ltd
Corporate Headquarters
Ground Floor, Block B, Regent Square, Kenilworth,
Cape Town, 7700, South Africa
Phone: 087 551-7644
International: +27 21 680 5066

IMS Corporate Headquarters

North America
Bluebird IMS Incorporated
3500 South Dupont Highway, Dover, DE 19901. USA.
Phone: +1 617-219-9484