The first manual on hospital administration, published in 1808, described a hospital steward as “an individual who [is] honest and above reproach,” with duties including the purchasing and management of hospital materials.1 Today, a steward’s job can be seen as ensuring the safe and effective use of clinical resources. The Joint Commission, for instance, requires antimicrobial stewardship programs to support appropriate antimicrobial use, including by monitoring antibiotic prescribing and resistance patterns.