# Combating Antimicrobial Resistance through Rapid Implementation of Available Guidelines and Evidence (CARRIAGE)

> **NIH VA I50** · VA SALT LAKE CITY HEALTHCARE SYSTEM · 2021 · —

## Abstract

Background: Under-investments in antimicrobial discovery, antimicrobial stewardship, and infection control
have reached crisis proportions. While these under-investments have been laid bare by SARS-CoV-2, antimi-
crobial-resistant infections—a more silent killer—are accelerating with three million illnesses, 48,000 deaths
and $35 billion in excess costs annually in the US, secondary to treatment failure and associated higher
morbidity and mortality. The ongoing pandemic of COVID-19, the disease caused by SARS-CoV-2, has also
revealed much about the limits of our public health infrastructure and the need to rapidly engage partners, dis-
seminate best practices, and adapt to changing conditions during times of widespread uncertainty. Our
national, integrated healthcare system for Veterans offers unique opportunities to significantly alter the course
of events and improve the outlook for our future through novel implementation and quality improvement efforts.
Objectives: The goal of this QUERI program is to continue the successes of its predecessor by addressing the
growing concern of antimicrobial resistance and other emerging infectious threats through strategies that train,
communicate, and coordinate front-line staff, operational leaders, and field experts. In doing so, we will
address the priority goals of our VA operational partners, increase the impact of VA research findings through
bi-directional partnerships and rigorous evaluation, and promote VA as a high reliability organization through
innovative implementation science. Three projects designed to implement key evidence-based practices in the
areas of infection prevention, biosurveillance, and antimicrobial stewardship will target the behaviors and
processes that facilitate the spread of antibiotic-resistant and other emerging pathogens, including (1) improv-
ing patient safety through overcoming barriers to Ultraviolet-C (UVC) no-touch room disinfection; (2) improving
implementation of strategies to prevent the spread of carbapenem-resistant organisms (CROs); and (3)
estimating the impact of two different electronic audit and feedback strategies on antimicrobial prescribing
practices. These efforts will be supplemented with time-sensitive rapid response projects guided by our
operational partners to assist their work with front-line providers across the country. We will also train a new
generation of VA implementation scientists through our mentoring core, led by investigators committed to
developing junior implementation researchers committed to careers improving the quality, safety, and value of
Veteran health care.
Methods: The program will employ complementary implementation strategies and theories guided by an
Implementation Core consisting of a team of notable VA implementation scientists with proven track records in
designing and executing programs to control antimicrobial resistance and prevent the spread of pathogens. We
will follow the principles of High Reliability Organizat...

## Key facts

- **NIH application ID:** 10187395
- **Project number:** 1I50HX003230-01A1
- **Recipient organization:** VA SALT LAKE CITY HEALTHCARE SYSTEM
- **Principal Investigator:** CHARLESNIKA T EVANS
- **Activity code:** I50 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2021-10-01 → 2025-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10187395

## Citation

> US National Institutes of Health, RePORTER application 10187395, Combating Antimicrobial Resistance through Rapid Implementation of Available Guidelines and Evidence (CARRIAGE) (1I50HX003230-01A1). Retrieved via AI Analytics 2026-05-29 from https://api.ai-analytics.org/grant/nih/10187395. Licensed CC0.

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