For an ASP to be sustainable, strategic support, a governance structure, and dedicated resources are pivotal.

(1) Get a statement from the hospital management on supporting the ASP

This statement can be integrated into the strategic goals of the hospitals and / or in the operational quality concept. As such it is approved by the top-level management of the hospital. The statement might include a principal statement to deploy ASP principles throughout the hospital and the commitment to deploy ressources including IT resources.

A 3- to 5-year strategy defining the scope of the local ASP and the priorities could pave the way for  the statement of the hospital management. Adapt the procedure to get a statement from the hospital management to the local situation.

Brief yearly action plans strengthen the accountability and adherence of the clinical staff and ensure the continuous development of the ASP.

(2) Set up a local ASP team with strong leadership and a dedicated project champion ("godmother or -father")

Establish a cross-hospital interdisciplinary AS team to develop an ASP and operate the program. Assemble a group of 3 to 5 senior staff spanning the relevant expertise fields. This includes IPC specialists, clinicians with experience in infectious diseases or internal medicine in smaller hospitals, hospital pharmacists, and/or microbiologists of the local or associated microbiology lab. Consider involving quality managers, and liaison staff from other pertinent departments (e.g. surgery). A dedicated IT single point of contact is very helpful. The designated people must be motivated and solution-oriented.

Identify 1 or 2 senior staff members for leading the first ASP group. The designated lead provides strategic guidance and support and ensures a cohesive process.

Identify the person in the group who acts as a project champion – ideally, somebody who is not in the lead of the ASP group. The project champion continuously advocates for the project at the stakeholder level and morally supports the ASP lead and team.  The project champion inspires the ASP team to find solutions. They liaise with stakeholders and negotiate solutions to secure their engagement.

A project champion should have strong communication skills, enjoy broad acceptance, and be familiar with the hospital’s and stakeholders’ politics.

(3) Obtain adequate resources for the staff of the ASP team and IT support

Resources required to plan, operate, and further develop an ASP vary from 1 for small hospitals (up to 200 beds) to 2.5 FTE (for hospitals with more than 500 beds), depending on the size and structure of the hospital.  This includes staff costs for an IPC specialist, infectious diseases senior physician, and a hospital pharmacist, as well as staff costs for the involvement of microbiologists, hospital hygiene, IT department, and quality manager. Further costs are incurred for adapting IT tools and producing other information materials.

For smaller hospitals it is recommended to cooperate with a larger hospital/hospital network with the corresponding ASP expertise (cooperation agreement).