At AMMI/CACMID this morning dr Andrew Morris said that AS should be reporting to the person with the most money… And I would agree with that, that having proper support for an AS program is the most important part… Being on the side of a desk in not conducive to long term sustainability and successes. So for those larger sites and health authorities I would agree that AS is a quality issue and that having it under pharmacy or micro would only make Stewardship a subsidiary of these programs and shift responsibility away from the larger group where it belongs. So yes AS should be under a quality or similar program.
However in smaller sites with limited resources a pharmacy or lab or medical advisory group could maintain a great AS program as long as the passion (and funding) exists.
AmS Programs have a better opportunity to succeed in a Portfolio that is multidisciplinary and is primarily driven by quality improvement and not focused on financial return. From my experience in trying to promote stewardship through both Pharmacy and Quality…no question ….Quality wins hands down