This work is created in collaboration
with International Futures Forum and financed by a grant of the Johnson & Johnson Foundation.
In the tapestry of healthcare, my role as an administrator often felt like a minor thread. Yet, as antibiotic resistance loomed large, that thread became a lifeline. The situation was dire; our regional hospital was an echo chamber of traditional medical practice, where antibiotics were a knee-jerk response to infections. The barriers were formidable—overworked doctors defaulted to what was quickest, organizational inertia resisted change, and institutional policies were outdated, anchored in isolated treatment rather than holistic wellness.I walked the tightrope between enforcing new protocols and honoring the wisdom of experienced physicians. The pushback was palpable; many saw the new approach as an academic ideal, impractical in the high-stress reality of a hospital. There were days I questioned the path we had taken, fears whispering that this vision might be too grand, too unattainable. Yet, I was driven by a personal conviction that sprang from a childhood spent in the embrace of nature, where the balance between all living things was evident. I was inspired by the idea that our hospital could mirror this harmony—an ecosystem where every decision rippled out to improve the whole. As a forerunner, breaking the mold wasn’t just about being different; it was about being right. It was about being responsible not just to our patients, but to the community, the environment, and future generations. My drive was fueled by the belief in a legacy of health, not just for the present, but for the planet we leave behind. I was all-in, with the full weight of my position, my beliefs, and my resolve.
First, we introduced a mandatory antibiotic stewardship program. This wasn’t merely a set of guidelines; it was a complete overhaul of our prescription protocol. We integrated an electronic health record (EHR) system with built-in decision support tools that flagged unnecessary antibiotic prescriptions, offering alternative management strategies based on the latest evidence-based practices. This technology was the linchpin in our strategy, serving as both a deterrent to overprescription and an educational resource for our staff. To support this, we constructed a robust organizational infrastructure. We formed an interdisciplinary stewardship team including infectious disease specialists, pharmacists, and nurses, all working in concert to review antibiotic use and provide feedback to prescribers. This team became the guardians of our antibiotic use, closely monitoring and mentoring clinicians on the front lines. Additionally, we recognized the power of data and the importance of transparency. We began publishing antibiotic usage metrics hospital-wide, creating a sense of accountability and a drive for departments to improve their practices. This openness wasn’t meant to shame but to inspire collective action towards a common goal. We also reached beyond the walls of our hospital, creating community dialogues to raise awareness about antibiotic resistance. These included public seminars, school programs, and partnerships with local media. The aim was to educate the public about the role they play in this ecosystem, from proper medication disposal to understanding when antibiotics might not be necessary. The impact was not immediate, but it grew. It was in the numbers—a steady decline in resistance rates. It was in the stories—farmers who saw their livestock thrive without antibiotics, families who understood the importance of balance in health. It was in the small daily victories, like a doctor choosing observation over prescription, or a patient asking about alternative treatments. These were feasible, replicable steps, a blueprint for others to follow. Our journey isn’t over, but each step we take carves a path for others in healthcare. We’ve shown that change isn’t just possible; it’s imperative for the well-being of all. And it starts with the courage to imagine, the resolve to act, and the vision to lead.