OPAT coordination consistency depends on a designated lead and checklist process, not on clinical suitability, US study finds

A mixed-methods study examined outpatient parenteral antimicrobial therapy (OPAT) delivery across the US Department of Veterans Affairs hospital system: 31 clinician interviews across six medical centres, plus a national organisational survey to which 106 of 139 VA medical centres (76.3%) responded Primary Study. Of the 78 responding centres that offered OPAT, only 76.9% had a designated person managing it. Interviews found recurring gaps in postdischarge communication and coordination concentrated at sites without a designated OPAT team, with uncertainty about roles and responsibilities a recurring theme. The study does not quantify how this governance variability translates into readmission or adverse-event rates, so the safety cost of under-resourced OPAT coordination remains unmeasured.

US Veterans Affairs hospital structures do not map directly onto NHS community antimicrobial therapy models.

The transferable finding is a governance question rather than a US-specific one: OPAT programmes without dedicated leadership and checklist-based processes show inconsistent postdischarge coordination, regardless of clinical suitability screening. That is a direct audit question for any OPAT service to put to its own governance structure — whether a designated lead and checklist process exists — irrespective of health system.