Preventing deaths from infection and tackling antimicrobial resistance by supporting and accrediting effective antimicrobial stewardship programmes globally

Accreditation process

Our initial call for applicants will be open from 1st September – 31st October 2022

The first step in becoming a client organisation in GAMSAS is to complete an online Screening Questionnaire.

This should be completed by the lead or champion for AMS within the organisation and it is important that they have management support for the application.

The questionnaire will allow us to gather some basic information about AMS in your country and details of current infrastructure and staffing within your organisation. Once we have reviewed this information we will contact you to either offer the opportunity to join GAMSAS or provide feedback on why we cannot accept your organisation as a client at this time.

Once accepted into GAMSAS we will assign an External Assessor and a Local AMS Expert from your region to support your organisation with completing a series of four on-line surveys to capture further  information about AMS in your country and your organisation’s current provision of AMS, microbiology laboratory services including AMR surveillance and Infection Prevention including Healthcare Associated Infection surveillance. These surveys will provide all the information required by the GAMSAS Accreditation Panel (a team of AMS experts from across the globe) to measure your organisation’s current position against our AMS Standards.

The Accreditation Panel will prepare a feedback report detailing areas of good practice and areas for improvement. The BSAC team will then support you to develop an action plan to address areas for improvement including education to address any gaps. This completes the first accreditation cycle and we will then provide ongoing support to make improvements and to the repeat self-assessment surveys again.

This iterative process will allow organisations to achieve optimal performance with respect to AMS, maximising use of local resources, and potential recognition as a Centre of Excellence.

The final step will be for your organisation to act as a mentor for other organisations in your region/country to support development of AMS and spread good practice.

Using these links you can learn more about accreditation of healthcare services and specifically of antimicrobial stewardship.

We have also prepared some answers to Frequently Asked Questions.

If you have any queries about GAMSAS please contact us.

END OF PROGRAMME ACCREDITATION

GAMSAS Accreditation Level One

Antimicrobial stewardship programme established, laboratory and clinical resource able to support informed antimicrobial prescribing and contribute to local surveillance.

Next steps: Progress with improvements to meet level two.

GAMSAS Accreditation Level One Commended

As for level one but recognising that no further progress can be made by the facility without new resource (infrastructure, equipment, personnel).

Next steps: Accredited as Centre of Excellence if key criteria met. Re-accreditation in 3 years.

GAMSAS Accreditation Level Two

Antimicrobial stewardship programme established, laboratory and clinical resource able to support informed antimicrobial prescribing and contribute to local and national surveillance. Able to provide advice and support to other facilities.

Next steps: Progress with improvements to meet level three.

GAMSAS Accreditation Level Two Commended

As for level two but recognising that no further progress can be made by the facility without new resource (infrastructure, equipment, personnel).

Next steps: Accredited as Centre of Excellence if key criteria met. Re-accreditation in 3 years.

GAMSAS Accreditation Level Three

Antimicrobial stewardship programme established, laboratory and clinical resource able to support informed antimicrobial prescribing and contribute to local, national, and global surveillance. Able to provide advice and support to other facilities nationally and globally. Capacity to act as partner mentor to one or more facilities.

Next steps: Accredited as Centre of Excellence. Ongoing engagement to support mentorship of other facilities. Re-accreditation in 3 years.

FAQs

GENERAL QUESTIONS

What is GAMSAS and what are its aims?

GAMSAS is a process developed by BSAC and led by experts in antimicrobial stewardship (AMS) which will set measurable standards for AMS and work in collaboration with client organizations to meet these standards and receive accreditation.
The aim of GAMSAS is to support healthcare organizations to build and sustain robust and measurable AMS programmes including support to enable them to contributions to local, national, and global data collection/surveillance which is a key ambition within the WHO AMR action plan.

Why is accreditation of AMS useful?

Accreditation of healthcare organizations or of specific clinical services is an evolving area and builds on two decades of quality improvement in healthcare. Through setting standards and measuting compliance with these standards we can provide assurance for care providers, patients and the public about the quality of care. If you would like to learn more about accreditation we have prepared two background summary documents.

What are the benefits of GAMSAS for organizations, clinicians and patients?

A robust AMS programme will optimise use of antibiotics within an organization with potential cost reductions in terms of medicines budget and more importantly reduction in drug resistant infections which are difficult to treat and associated with longer hospital stays and increased costs.
Clinicians involved and engaged with an AMS programme will be assured that they are using antibiotics appropriately through use of local infection management guidelines. In addition they will have access to bespoke education on AMS and opportunities for local audit, quality improvement initiatives and research.
Patients with infections will be assured of receiving high quality evidence-based treatment potentially allowing a shorter hospital stay and reducing their risk of healthcare associated and drug resistant infections.

APPLYING TO JOIN GAMSAS

How does an organization apply to join the GAMSAS?

The first step in becoming a client organization in GAMSAS is to complete an online Screening Questionnaire.
This should be completed by the lead or champion for AMS within the organization and it is important that they have management support for the application.
The questionnaire will allow us to gather some basic information about AMS in your country and details of current infrastructure and staffing within your organization. Once we have reviewed this information we will contact you to either offer the opportunity to join GAMSAS or provide feedback on why we cannot accept your organisaztion as a client at this time.

How much does it cost to participate in GAMSAS?

BSAC has a flexible fee structure to enable organisations from both high income countries and low/middle income countries to join GAMSAS. Agreement of a specific fee will be discussed once a client organisation has completed an initial screening questionnaire and been deemed suitable for GAMSAS participation.

Are funding grants available to support organisations to participate in GAMSAS?

In some circumstances organisations with limited resources may be offered free participation with costs covered via BSAC grants. Please contact the GAMSAS team for more information.

Specific funding is currently available via a collaboration with Pfizer to address disparities in AMS provision due to lack of resources and/or health inequalities.

Our organisation does not yet have an AMS service, can we apply to GAMSAS?

Yes we are keen to work with organisations who are at the start of their AMS journey. Providing your organisation meets some basic infrastructure and staffing requirements which we ask about in our Screening Questionnaire you can be considered.

Our organisation has a well established AMS service, would GAMSAS be useful?

Yes we are keen to work with organisations with established AMS services wishing to become accredited, as they can focus on enhancing their service through quality improvement activities and act as mentors for other organisations with less developed AMS.

THE GAMSAS PROCESS

Which hospital staff require to be involved in the GAMSAS process?

The AMS Lead or champion is the key staff member but other members of the AMS team (if one is established) plus leads for Infection Prevention and Microbiology services will also be required to contribute. A multi-professional approach is encouraged to support engagement of all staff groups involved in AMS.

Once accepted as GAMSAS client organisation what happens next?

When an organisation is accepted as a client some initial documentation will be completed to formalise an agreement with BSAC and ensure the client organisation has the capacity to commit to the actions required for the GAMSAS process.

An External Assessor and a Local AMS expert (based within the same country/region) will be assigned to work with the client organisation.

What information do hospitals require to submit within the GAMSAS process?

The initial self-assessment process involves completion by the client organisation of three online questionnaires about systems and practice within the organisation for AMS, IPC and laboratory services and one questionnaire about the national AMS landscape in the country where the organisation is based. Following completion of these questionnaires the GAMSAS team may request additional documents to be submitted electronically.

What does the GAMSAS accreditation process involve and how long does it take?

The process involves a cumulative cycle of supported and self-assessment activities over a 2-3 year period comprising the following:

  • Information gathering via self-assessment questionnaires with support from GAMSAS team (BSAC staff, an External assessor and Local expert).
  • Review of information and preparation of a report and recommendations by GAMSAS team in collaboration with client organisation.
  • Consideration by Accreditation panel and Accreditation level awarded.
  • Recommendations and actions for improvement agreed to facilitate higher level of accreditation (if applicable/feasible).
What is the role of an appointed local AMS expert in GAMSAS?

Local experts will be identified in the country or locality of a client organisation under assessment. They will work with the External assessor and liaise with the client to provide a desk-top assessment of the capacity of the locality and organisation.

What is the role of the External Assessor in GAMSAS?

External assessors are appointed for their expertise and experience following self-nomination or nomination by a national body/organisation. They will work with the local expert and liaise with the client to provide a desk-top assessment of the capacity of the locality and organisation.

Following completion and review of the questionnaires the external assessor will lead a virtual Q&A session with the client and local expert and a draft report will be presented and discussed, The Final report and recommendations for action will then be presented to the client by the external assessor prior to consideration by the Accreditation Panel.

What is the role of the Accreditation Panel in GAMSAS?

The Accreditation Panel will comprise members from across differing health economies, a minimum of 5 people who will be called to meet and assess applications. The mix of panel members will be determined by the applications received. The panel will discuss each application report with the External assessor for each client and agree on the accreditation level achieved as well as suggested improvement actions.

What levels of accreditation are possible and how do they vary?

GAMSAS accreditation is an iterative process so that hospitals can initially achieve one of 5 levels then work towards achieving a higher level if feasible.
The table below illustrates the levels within GAMSAS:

Accreditation level Description Next steps
One Antimicrobial stewardship programme established,
laboratory and clinical resource able to support informed
antimicrobial prescribing and contribute to local
surveillance.
Progress with improvements to meet level two.
One commended As for level one but recognising that no further progress can be made by the facility without new resource (infrastructure, equipment, personnel). May be accredited as Centre of Excellence if key criteria met. Re-accreditation in 3 years.
Two Antimicrobial stewardship programme established,
laboratory and clinical resource able to support informed
antimicrobial prescribing and contribute to local and
national surveillance. Able to provide advice and support to
other facilities.
Progress with improvements to meet level three.
Two commended As for level two but recognising that no further progress can be made by the facility without new resource (infrastructure, equipment, personnel). May be accredited as Centre of Excellence if key criteria met.

Re-accreditation in 3 years.

Three Antimicrobial stewardship programme established, laboratory and clinical
resource able to support informed antimicrobial prescribing and contribute to
local, national, and global surveillance.
Able to provide advice and support to other facilities nationally and globally.
Capacity to act as partner mentor to one or more facilities.Antimicrobial stewardship programme established, laboratory and clinical
resource able to support informed antimicrobial prescribing and contribute to
local, national, and global surveillance.
Able to provide advice and support to other facilities nationally and globally.
Capacity to act as partner mentor to one or more facilities.
Accredited as Centre of Excellence.

Ongoing engagement to support mentorship of other facilities.

Re-accreditation in 3 years.

FOLLOW UP AND ONGOING SUPPORT WITHIN GAMSAS

Once accredited what is the process to follow up/maintain accreditation?

Accreditation will require to be renewed every 3 years but it is expected that clients will build upon AMS activities to address areas for improvement identified by the Accreditation panel. This will include utilisation of recommended education resources along with any bespoke education support agreed.

An interim visit or virtual meeting will be convened at around 18 months to discuss maintenance and further development of AMS.

What does being a ‘Centre of Excellence’ mean for an organisation?

Being accredited as a Centre of Excellence acknowledges that the organisation is a leader in the field of AMS through having a robust and measurable AMS programme, contributing to national and global surveillance of antimicrobial use and resistance and shared learning to mentor other organisations in their locality/region.

The establishment of Centres of Excellence for AMS will allow organisations to enhance their reputation as a high quality care provider and facilitate shared learning with others in their region/country. The reputational benefit will attract clinical staff wishing to work there and provide reassurance to patients on provision of high quality care.

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