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Optimizing Antibiotic Stewardship in California NICUs

The Optimizing Antibiotic Stewardship in California NICUs (OASCN) collaborative aims to implement and evaluate an innovative, scalable antibiotic stewardship intervention which pairs prospective audit and feedback with the ECHOTM (Extension for Community Healthcare Outcomes) collaborative learning model. ECHOTM is an evidence-based method of practice dissemination used globally in >120 health collaborations since 2003 and is actively endorsed by the AAP.

The OASCN collaborative is grounded in a faculty-facilitated, case-based learning model tailored to how clinicians are inclined to learn and build practice consensus.

Why we care about this topic

We all would like to evolve our practice towards the safest and most appropriate use of antibiotics for our newborns. Unnecessary and/or inappropriate antibiotic use continues to be a problem in the NICU setting with the potential for harm to neonates. At the same time, professional associations, accreditors, and ongoing national initiatives highlight the increasing urgency of antimicrobial resistance and stewardship.

Our approach

We have designed this collaborative with partners at the RAND Corporation and The Lundquist Institute in Los Angeles to include the latest in collaborative learning approaches. The OASCN collaborative will use the AAP-endorsed ECHOTM (Extension for Community Healthcare Outcomes) model, a telementoring video conference platform to facilitate learning among a multidisciplinary faculty panel and participants. Participating NICUs will join weekly or biweekly collaborative learning sessions including de-identified case presentations and discussion. The OASCN collaborative aims to reduce antibiotic utilization and address challenges with implementing stewardship.

Why your NICU should join

  • Participate in interactive, case-based learning sessions guided by a multidisciplinary faculty panel on NICU antibiotic prescribing
  • Share experiences and lessons with NICUs across the state on optimizing antibiotic use
  • Learn and apply principles of implementing quality improvement
  • Reduce antibiotic utilization

Additional benefits

  • Open to NICUs of all sizes and QI experience
  • This collaborative is supported by a federal grant from the Agency for Healthcare Research and Quality (AHRQ), which allows CPQCC to waive its usual fee for QI collaboratives
  • Contribute to research on video-based collaborative learning for improving the collaborative experience and dissemination in peer-reviewed literature
  • ABP Maintenance of Certification Part 4 credit available to participating physicians (CPQCC will charge a nominal fee for physicians availing of this benefit)

Expanding target population to all gestational ages

The primary goal of the OASCN collaborative is to safely reduce antibiotic use rate for all infants at participating NICUs. The primary focus was planned to be late preterm and term babies to allow focused effort in this area. We have heard from many sites that they are interested in reducing antibiotic use in preterm infants as well. Based on this feedback from interested and already registered centers, we’ve broadened the scope to be inclusive of all gestational ages. 
This means that your center can focus on any target population of your choice. We will continue to involve registered and interested NICUs in the development of this collaborative effort toward more responsible use of antibiotics for infants admitted to NICUs.


  • June



    OASCN virtual information session.

  • July


    Registration for OASCN opens. 

  • January



    OASCN collaborative kickoff meeting.



    Collaborative learning sessions begin with OASCN sites. 

  • December



    Collaborative learning sessions end.

  • June



    Data collection concludes.