JCAHO Tweaks Emergency Departments’ Pneumonia Treatment Standards

A Novel Method to Link and Validate Routinely Collected Emergency Department Clinical Data to Measure Quality of Care

“…Our results also demonstrate that the performance calculated for pneumonia patients and suspected acute myocardial infarction/acute coronary syndrome patients was far from meeting established guidelines, 4,6 and improvement is required in our ED. An accurate and efficient process of quality evaluation that allows for timely and appropriate feedback will greatly aid in monitoring and encouraging improvement.…”

“…There is increasing emphasis on measuring quality of care and patient safety in the ED, with many groups focusing on the development of indicators. 4,[6][7][8] Measuring performance with respect to such indicators can be difficult and costly. Comparatively little work has been done to assist hospitals to develop novel, innovative, and lower cost means of doing so.…”

Time for first antibiotic dose is not predictive for the early clinical failure of moderate–severe community-acquired pneumonia

“…This approach would lead to the administration of antibiotics to many patients in whom the diagnosis of pneumonia is still in doubt, leading to an increasing rate of inappropriate antibiotic use, antibiotic resistance, antibiotic-related side-effects and an decrease in the yield of subsequently required diagnostic tests [ 28 ]. Furthermore, although some patients may benefit of the early administration of antibiotics, there is a risk to other patients who are treated concurrently and may not receive the same priority as patients with suspected pneumonia [ 13 , 14 ].…”

Linking Joint Commission Inpatient Core Measures and National Patient Safety Goals with Evidence

“…For instance, in a sample of 86 patients with discharge diagnoses of pneumonia, Metersky et al found that approximately 20% of these cases had atypical presentations (lack of infiltrate on chest x-ray, normal oximetry) that would be potential valid reasons for delays in antibiotic administration (101). Given this diagnostic uncertainty, rewarding 100% adherence to antibiotic delivery within 6 hours to all patients with suspected pneumonia may lead to inappropriate use of antibiotics and divert scarce resources from those who are more acutely ill (36,101). Thus, efforts to drive performance of this core measure need to be concurrent with care pathways that include prompt diagnostic workup, disease recognition, and appropriate treatment.…”