Table 1.

Themes from qualitative analysis.

Themes	Description
Captures and controls attention	Timeout oriented and forced attention to the antibiotic renewal task
Enhances informed and deliberative reasoning	Timeout prompted clinicians to “think twice” about continuing antibiotics. It structured the reasoning processes and provided useful information to reduce uncertainty
Redirects decision direction by making inappropriate vancomycin and piperacillin/tazobactam discontinuation easier than continuation	The process of using something new is effortful. The timeout system required clinicians to stop and think in order to continue targeted antibiotics, which cost time and effort
Fosters autonomy and improves team empowerment	Timeout increased personal responsibility and autonomy. The result was a sense of decreased dependency on the infectious disease pharmacist. There was evidence of an adversarial relationship between clinicians and stewards before the intervention
Limits use of emotion-based heuristics	This heuristic assumes the strength of the felt emotion is strongly correlated with the logic of decision-making. People answer the question of what they think with what they feel. When clinicians previously sought approval from stewards, they were asked to justify their decisions, which prompted them to “reach” for a reason to support what they had already decided to do