Improving the quality of care for patients with pneumonia in very small hospitals - PubMed (original) (raw)
Clinical Trial
. 2003 Feb 10;163(3):326-32.
doi: 10.1001/archinte.163.3.326.
Affiliations
- PMID: 12578513
- DOI: 10.1001/archinte.163.3.326
Clinical Trial
Improving the quality of care for patients with pneumonia in very small hospitals
Laurie Anne Chu et al. Arch Intern Med. 2003.
Abstract
Background: Despite the publication of guidelines for the management of pneumonia, significant variation in care continues to exist. While there have been several published reports of quality improvement projects for pneumonia, there are few data on the effectiveness of these efforts in small hospitals. The purpose of this study was to demonstrate that a project implemented by a quality improvement organization in small hospitals would lead to an improvement in care that could not be accounted for by secular trends in the management of pneumonia.
Methods: Medicare-insured hospital admissions for pneumonia were reviewed from 20 small hospitals in Oklahoma (intervention group) at baseline and after feedback. Project intervention included onsite feedback presentations to the medical staff, samples of performance improvement materials, and comparative measures of performance of predefined quality indicators. A second group of 16 demographically similar hospitals (control group) was selected for review during the same 2 periods. These hospitals subsequently underwent an identical intervention with a follow-up assessment.
Results: Statistically significant improvements in process measures were demonstrated in the intervention hospitals, including performance of a sputum (P<.01) and blood (P<.001) cultures, antibiotic administration within 4 hours of hospital admission (P<.001), and administration of the first dose of antibiotic in the emergency department (P<.001). These measures in the control hospitals did not change significantly (P =.93, .08, .79, and .52, respectively) during the 2 periods.
Conclusions: Improvements in processes of care achieved by the intervention hospitals resulted from activities initiated because of participation in a quality improvement organization-directed project. This study demonstrated the effectiveness of quality improvement activities in very small hospitals.
Similar articles
- A statewide initiative to improve the care of hospitalized pneumonia patients: The Connecticut Pneumonia Pathway Project.
Meehan TP, Weingarten SR, Holmboe ES, Mathur D, Wang Y, Petrillo MK, Tu GS, Fine JM. Meehan TP, et al. Am J Med. 2001 Aug 15;111(3):203-10. doi: 10.1016/s0002-9343(01)00803-8. Am J Med. 2001. PMID: 11530031 - Community-acquired pneumonia in Oklahoma: characteristics and management of hospitalized Medicare beneficiaries.
Bratzler DW, Murray CK, Bumpus LJ, Moore LL. Bratzler DW, et al. J Okla State Med Assoc. 1996 Mar;89(3):87-92. J Okla State Med Assoc. 1996. PMID: 8919852 - Improving the care of patients with community-acquired pneumonia: a multihospital collaborative QI project.
Metersky ML, Galusha DH, Meehan TP. Metersky ML, et al. Jt Comm J Qual Improv. 1999 Apr;25(4):182-90. doi: 10.1016/s1070-3241(16)30437-0. Jt Comm J Qual Improv. 1999. PMID: 10228910 - [Volume and health outcomes: evidence from systematic reviews and from evaluation of Italian hospital data].
Amato L, Colais P, Davoli M, Ferroni E, Fusco D, Minozzi S, Moirano F, Sciattella P, Vecchi S, Ventura M, Perucci CA. Amato L, et al. Epidemiol Prev. 2013 Mar-Jun;37(2-3 Suppl 2):1-100. Epidemiol Prev. 2013. PMID: 23851286 Review. Italian. - Quality improvement in Germany.
Paeger A. Paeger A. Jt Comm J Qual Improv. 1997 Jan;23(1):38-46. doi: 10.1016/s1070-3241(16)30293-0. Jt Comm J Qual Improv. 1997. PMID: 9116883 Review.
Cited by
- A mixed-methods descriptive study on the role of continuous quality improvement in rural surgical and obstetrical stability: Considering enablers, challenges and impact.
Kornelsen J, Cameron A, Stoll K, Skinner T, Humber N, Williams K, Ebert S. Kornelsen J, et al. PLoS One. 2024 Jun 6;19(6):e0300977. doi: 10.1371/journal.pone.0300977. eCollection 2024. PLoS One. 2024. PMID: 38843178 Free PMC article. - Continuing Quality Assessment Program Improves Clinical Outcomes of Hospitalized Community-Acquired Pneumonia: A Nationwide Cross-Sectional Study in Korea.
An TJ, Myong JP, Lee YH, Kwon SO, Shim EK, Shin JH, Yoon HK, Jeong SH. An TJ, et al. J Korean Med Sci. 2022 Aug 1;37(30):e234. doi: 10.3346/jkms.2022.37.e234. J Korean Med Sci. 2022. PMID: 35916046 Free PMC article. - Improving antibiotic prescribing for community-acquired pneumonia in a provincial hospital in Northern Vietnam.
Do NTT, Li R, Dinh HTT, Nguyen HTL, Dao MQ, Nghiem TNM, Nadjm B, Luong KN, Cao TH, Le DTK, Cluzeau F, Ngo CQ, Chu HT, Vu DQ, van Doorn HR, Roberts CM. Do NTT, et al. JAC Antimicrob Resist. 2021 May 17;3(2):dlab040. doi: 10.1093/jacamr/dlab040. eCollection 2021 Jun. JAC Antimicrob Resist. 2021. PMID: 34046595 Free PMC article. - Interventions to improve antibiotic prescribing practices for hospital inpatients.
Davey P, Marwick CA, Scott CL, Charani E, McNeil K, Brown E, Gould IM, Ramsay CR, Michie S. Davey P, et al. Cochrane Database Syst Rev. 2017 Feb 9;2(2):CD003543. doi: 10.1002/14651858.CD003543.pub4. Cochrane Database Syst Rev. 2017. PMID: 28178770 Free PMC article. Review. - Strategies to enhance rational use of antibiotics in hospital: a guideline by the German Society for Infectious Diseases.
de With K, Allerberger F, Amann S, Apfalter P, Brodt HR, Eckmanns T, Fellhauer M, Geiss HK, Janata O, Krause R, Lemmen S, Meyer E, Mittermayer H, Porsche U, Presterl E, Reuter S, Sinha B, Strauß R, Wechsler-Fördös A, Wenisch C, Kern WV. de With K, et al. Infection. 2016 Jun;44(3):395-439. doi: 10.1007/s15010-016-0885-z. Infection. 2016. PMID: 27066980 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical