Quality Measures for Pneumonia Patients

The pneumonia (PN), care "bundle" consists of the measures listed individually below, and are considered best-practice, evidence-based care for pneumonia patients.

When combined these measures are proven to provide better outcomes. At Southwest, our vision is, "Exceptional medicine. Extraordinary care. Every person."  Following quality measures such as these prescribed by CMS for pneumonia care is part of our strategic quality plan.  

Source for WA State and National Average: Hospital Quality Alliance 7/16/2007

² SWMC Influenza Vaccine data time period is October 2006-March 2007 (flu season). WA State and National Average data is also appropriate to the flu season, from approximately November through March.                                                         

³ The SWMC Board of Directors, Infection Control, and Medical Staff Leadership discussed the recommendations adopted by HQA and determined SWMC will not adopt this protocol in its entirety. The Infectious Disease Society and the Thoracic Society recommend pneumonia is treated with two antibiotics per a 1998 and 1999 retrospective study. SWMC follows the recommendation for two antibiotic doses for patients in the ICU; however, for patients not in the ICU, SWMC gives one antibiotic, Rocefin. SWMC Infection Control discourages its medical staff from giving more than one antibiotic to non-ICU patients due to antibiotic resistance, side effects, and cost. Further, in subsequent smaller prospective studies, outcomes are no better for patients who receive two antibiotics, i.e. there are no more complications of PN when one antibiotic is given, such as respiratory failure, development of empyema, and increased length of stay. SWMC monitors its outcome indicators to ensure SWMC care is similar, or better than other hospitals in the US .               

Following includes a graphical display of Southwest performance compared to WA State and US Hospital average performance. This is the same information as in the table above. In addition, each measure is described in greater detail.

Percent of Pneumonia Patients Assessed and Given Influenza Vaccination Why is this Important? Flu shots reduce the risk of influenza, a serious and sometimes deadly lung infection that can spread quickly in a community or facility. Hospitals should check to make sure that pneumonia patients, particularly those who are age 50 or older, get a flu shot during flu season to protect them from another lung infection and to help prevent the spread of influenza.

² SWMC Influenza Vaccine data time period is October 2006-March 2007 (flu season). WA State and National Average data is also appropriate to the flu season, from approximately November through March.                     

Percent of Pneumonia Patients Assessed and Given Pneumococcal Vaccination Why is this Important? The pneumococcal vaccine may help you prevent, or lower the risk of complications of pneumonia caused by bacteria. It may also help you prevent future infections. Patients with pneumonia should be asked if they have been vaccinated recently for pneumonia and, if not, should be given the vaccine.

Percent of Pneumonia Patients Given Initial Antibiotic(s) within 4 Hours After Arrival Why is this Important? Antibiotics are used to treat adults with pneumonia caused by bacteria. Early treatment with antibiotics can cure bacterial pneumonia and reduce the possibility of complications. This information shows the percent of patients who were given their first dose of antibiotics within 4 hours of arrival at the hospital. Patients who get pneumonia during their stay at the hospital are not counted in this measure.

Percent of Pneumonia Patients Given Oxygenation Assessment Why is this Important? Pneumonia can lower the oxygen in your blood because the air spaces in your lungs fill with mucus. The oxygen you breathe does not get into your bloodstream. It is important that the amount of oxygen in your blood be measured within 24 hours of arriving at the hospital to see if you need oxygen therapy. The assessment may include an ABG (arterial blood gas) or pulse oximetry (electrodes attached to a part of your body like a finger, earlobe, or skin fold).

Percent of Pneumonia Patients Given Smoking Cessation Advice/Counseling Why is this Important? Smoking damages your lungs and can make it hard to breath. Smoking increases your chances of getting pneumonia or other chronic lung diseases like emphysema and bronchitis. Smoking is also linked to lung cancer, heart disease, and stroke, and can cause premature death. It is important for you to get information to help you quit smoking before you leave the hospital. Quitting may reduce your chance of getting pneumonia again.

Percent of Pneumonia Patients Given the Most Appropriate Initial Antibiotic(s) Why is this Important? Pneumonia is a lung infection that is usually caused by bacteria or a virus. If pneumonia is caused by bacteria, hospitals will treat the infection with antibiotics. Different bacteria are treated with different antibiotics. Please see below for an explanation of SWMC protocol for this measure.

³The SWMC Board of Directors, Infection Control, and Medical Staff Leadership discussed the recommendations adopted by HQA and determined SWMC will not adopt this protocol in its entirety. The Infectious Disease Society and the Thoracic Society recommend pneumonia is treated with two antibiotics per a 1998 and 1999 retrospective study. SWMC follows the recommendation for two antibiotic doses for patients in the ICU; however, for patients not in the ICU, SWMC gives one antibiotic, Rocefin. SWMC Infection Control discourages its medical staff from giving more than one antibiotic to non-ICU patients due to antibiotic resistance, side effects, and cost. Further, in subsequent smaller prospective studies, outcomes are no better for patients who receive two antibiotics, i.e. there are no more complications of PN when one antibiotic is given, such as respiratory failure, development of empyema, and increased length of stay. SWMC monitors its outcome indicators to ensure SWMC care is similar, or better than other hospitals in the US .   

Percent of Pneumonia Patients Having a Blood Culture Performed Prior to First Antibiotic Received in Hospital Why is this Important? Different types of bacteria can cause pneumonia. A blood culture is a test that lets the health care provider know which bacteria may have caused your pneumonia, and which antibiotic should be prescribed. It is best to do the blood culture within 24 hours of arrival at the hospital and before antibiotics are started. It is also important to start antibiotics as soon as possible. A blood culture lets your health care provider know how to best treat you and if any precautions are necessary to prevent the spread of your illness.