2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T6e1,Describe the workload associated with using telehealth to support Antimicrobial Stewardship efforts at Veterans Affairs Medical Centers (VAMCs) without local infectious diseases (ID) expertise. A mixed-methods process assessment to evaluate workload and workflow associated with Videoconference Antimicrobial Stewardship Teams (VASTs). Rural VAMC champions paired with ID consultants at geographically distant VAMCs to form VASTs. Total workload estimates were based on time that champions and ID consultants allocated to VAST activities. Clinical Procedural Terminology (CPT) codes were used to estimate the workloads for clinical encounters. Role-based process maps were developed to understand variation in implementation by VAMC. The average workload that champions and ID consultants allocated to VAST activities was 6.7% (range 1.0%-20.0%) and 8.4% (range 2.0%-12.5%) full-time equivalents (FTEs), respectively. Clinical encounters completed by ID consultants contributed an average of 1.4% (range < 0.01%-2.5%) FTEs to the workload. The average proportion of FTEs required to sustain VASTs was 13.0% (range 3.0%-31.6%). Process maps showed four phases common to each VAST's workflow: case identification, meeting preparation, team meeting, and documentation. The tasks associated with each phase varied between VASTs. Champions carried out most tasks related to case finding and meeting preparation; the ID consultants completed most documentation tasks. The distribution of tasks within and among the VASTs indicated opportunities to improve workflow efficiency. Investing <12.5% of the FTE allocated to VA Antimicrobial Stewardship programs to support the time of an ID consultant from another VAMC can help rural VAMCs achieve staffing sustainability.31:Tb4f,Abstract Objective: Describe the workload associated with using telehealth to support Antimicrobial Stewardship efforts at Veterans Affairs Medical Centers (VAMCs) without local infectious diseases (ID) expertise. Design: A mixed-methods process assessment to evaluate workload and workflow associated with Videoconference Antimicrobial Stewardship Teams (VASTs). Setting and Participants: Rural VAMC champions paired with ID consultants at geographically distant VAMCs to form VASTs. Methods: Total workload estimates were based on time that champions and ID consultants allocated to VAST activities. Clinical Procedural Terminology (CPT) codes were used to estimate the workloads for clinical encounters. Role-based process maps were developed to understand variation in implementation by VAMC. Results: The average workload that champions and ID consultants allocated to VAST activities was 6.7% (range 1.0%–20.0%) and 8.4% (range 2.0%–12.5%) full-time equivalents (FTEs), respectively. Clinical encounters completed by ID consultants contributed an average of 1.4% (range < 0.01%–2.5%) FTEs to the workload. The average proportion of FTEs required to sustain VASTs was 13.0% (range 3.0%–31.6%). Process maps showed four phases common to each VAST’s workflow: case identification, meeting preparation, team meeting, and documentation. The tasks associated with each phase varied between VASTs. Champions carried out most tasks related to case finding and meeting preparation; the ID consultants completed most documentation tasks. Conclusions: The distribution of tasks within and among the VASTs indicated opportunities to improve workflow efficiency. Investing <12.5% of the FTE allocated to VA Antimicrobial Stewardship programs to support the time of an ID consultant from another VAMC can help rural VAMCs achieve staffing sustainability. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Mixed-Methods Process Assessment: study design Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Mixed-Methods Process Assessment (study design). 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Clinical encounters completed by ID consultants contributed an average of 1.4% (range < 0.01%-2.5%) FTEs to the workload. The average proportion of FTEs required to sustain VASTs was 13.0% (range 3.0%-31.6%). Process maps showed four phases common to each VAST's workflow: case identification, meeting preparation, team meeting, and documentation. The tasks associated with each phase varied between VASTs. 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Healthcare System"}]},{"given":"Charlesnika","family":"Evans","sequence":"additional","affiliation":[{"name":"VA Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital"},{"name":"Center for Health Services and Outcomes Research, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine"}]}],"issued":{"date-parts":[[2026,5,4]]},"member":"56","prefix":"10.1017","source":"Crossref","volume":null,"created":{"date-time":"2026-05-04T05:21:09Z","timestamp":1777872069000,"date-parts":[[2026,5,4]]},"indexed":{"date-time":"2026-05-05T02:59:27Z","timestamp":1777949967638,"date-parts":[[2026,5,5]]},"license":[{"URL":"https://www.cambridge.org/core/terms","start":{"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000,"date-parts":[[2026,5,4]]},"delay-in-days":0,"content-version":"unspecified"}],"subject":[],"abstract":"$31","language":"en","relation":{},"resource":{"primary":{"URL":"https://www.cambridge.org/core/product/identifier/S0899823X26104528/type/journal_article"}},"subtitle":[],"assertion":[{"name":"copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"},"label":"Copyright","value":"© Department of Veterans Affairs, 2026"},{"name":"license","group":{"name":"copyright_and_licensing","label":"Copyright and 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Summary and tags are based solely on the abstract and results sections provided, not the full text.","value_numeric":null}],"summaries":{"what_studied":"A mixed-methods process assessment evaluated the workload and workflow of Videoconference Antimicrobial Stewardship Teams (VASTs), which paired rural VA Medical Center (VAMC) champions with infectious diseases (ID) consultants at distant VAMCs to support antimicrobial stewardship where local ID expertise was lacking.","key_result":"Champions and ID consultants allocated an average of 6.7% and 8.4% FTEs to VAST activities, respectively; combined, VASTs required an average of 13.0% FTEs (range 3.0%–31.6%) to sustain. Clinical encounters by ID consultants added only ~1.4% FTE on average. Workflow mapped to four phases: case identification, meeting preparation, team meeting, and documentation.","limitations":"Workload estimates relied on self-reported time allocation and CPT code counts rather than direct time-motion measurement. Small number of VAST sites with wide FTE ranges limits generalizability. Process maps captured variation but could not fully quantify inefficiencies.","practice_takeaway":"Rural VAMCs without on-site ID expertise can sustain telehealth antimicrobial stewardship by investing less than 12.5% of an ID consultant's FTE from another VAMC. Redistributing tasks—such as shifting some documentation from ID consultants to local champions—may improve efficiency further."}}],"initialOffset":1,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"study_design","value":"Mixed-Methods Process Assessment"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Study Designs","href":"/hub/tag/study_design"},{"name":"Mixed-Methods Process Assessment"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"study_design","hub_tag_value":"Mixed-Methods Process Assessment"}}}]]

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