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AHRQ Research Studies Date
Topics
- Adverse Events (2)
- Alcohol Use (1)
- Antibiotics (6)
- Antimicrobial Stewardship (2)
- Cardiovascular Conditions (3)
- Children/Adolescents (4)
- Chronic Conditions (1)
- Clinical Decision Support (CDS) (2)
- Community-Acquired Infections (6)
- COVID-19 (1)
- Decision Making (1)
- Dental and Oral Health (1)
- Diagnostic Safety and Quality (2)
- Elderly (2)
- Emergency Department (4)
- Evidence-Based Practice (2)
- Guidelines (3)
- Healthcare-Associated Infections (HAIs) (3)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (3)
- Healthcare Utilization (1)
- Heart Disease and Health (2)
- Home Healthcare (1)
- Hospitalization (6)
- Hospital Readmissions (2)
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- Infectious Diseases (5)
- Injuries and Wounds (1)
- Inpatient Care (3)
- Long-Term Care (2)
- Medicare (3)
- Medication (6)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (1)
- Neurological Disorders (1)
- Newborns/Infants (1)
- Nursing Homes (3)
- Outcomes (3)
- Patient Safety (2)
- (-) Pneumonia (24)
- Prevention (3)
- Provider (1)
- Provider: Physician (1)
- Quality Improvement (1)
- Quality of Care (1)
- Respiratory Conditions (11)
- Risk (3)
- Sepsis (2)
- Stroke (1)
- Substance Abuse (1)
- Surgery (1)
- Vaccination (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 24 of 24 Research Studies DisplayedTandan M, Zimmerman S, Sloane PD
Which nursing home residents with pneumonia are managed on-site and which are hospitalized? Results from 2 years' surveillance in 14 US homes.
Pneumonia is a frequent cause of hospitalization among nursing home (NH) residents, but little information is available as to how clinical presentation and other characteristics relate to hospitalization, and the differential use of antimicrobials based on hospitalization status. This study examined how hospitalized and nonhospitalized NH residents with pneumonia differ. The investigators concluded that respiratory rate was associated with hospitalization but was not documented for more than a quarter of residents.
AHRQ-funded; HS022298.
Citation: Tandan M, Zimmerman S, Sloane PD .
Which nursing home residents with pneumonia are managed on-site and which are hospitalized? Results from 2 years' surveillance in 14 US homes.
J Am Med Dir Assoc 2020 Dec;21(12):1862-68.e3. doi: 10.1016/j.jamda.2020.07.028..
Keywords: Elderly, Nursing Homes, Pneumonia, Respiratory Conditions, Hospitalization
Klompas M, Imrey PB, Yu PC
Respiratory viral testing and antibacterial treatment in patients hospitalized with community-acquired pneumonia.
Researchers studied the frequency of respiratory viral testing and its associations with antimicrobial utilization in adult patients hospitalized with community-acquired pneumonia. They found that, of patients with pneumonia on admission, 24.5% were tested for respiratory viruses, 94.8% were tested for influenza, and 20.7% were tested for other viruses. They concluded that a minority of patients hospitalized with pneumonia were tested for respiratory viruses; only a fraction of potential viral pathogens were assayed; and patients with positive viral tests often received long antibacterial courses.
AHRQ-funded; HS025008; HS024277.
Citation: Klompas M, Imrey PB, Yu PC .
Respiratory viral testing and antibacterial treatment in patients hospitalized with community-acquired pneumonia.
Infect Control Hosp Epidemiol 2021 Jul;42(7):817-25. doi: 10.1017/ice.2020.1312..
Keywords: Pneumonia, Respiratory Conditions, Antibiotics, Medication
Deshpande A, Richter SS, Haessler S
De-escalation of empiric antibiotics following negative cultures in hospitalized patients with pneumonia: rates and outcomes.
This study assessed antibiotic de-escalation practices across hospitals and their associations with outcomes in hospitalized patients diagnosed with pneumonia with negative cultures. The authors included 14,170 adults admitted with pneumonia in 2010-2015 to 164 US hospitals if they had negative blood and/or respiratory cultures and received both anti-MRSA and antipseudomonal agents other than quinolones. If empiric drugs were stopped on day 4 while continuing another antibiotic it was defined at de-escalation. Patients were propensity adjusted for de-escalation and compared on in-hospital 14-day mortality, late deterioration with ICU transfer, length-of-stay (LOS) and costs. Thirteen percent (1924 patients) had both initial empiric drugs stopped by hospital day 4. De-escalation rates at hospitals ranged from 2-35% and the established rate quartiles were not significantly associated with outcomes. Even at hospitals in the top quartile of de-escalation, the de-escalation rates were lower than 50%.
AHRQ-funded; HS025026; HS024277.
Citation: Deshpande A, Richter SS, Haessler S .
De-escalation of empiric antibiotics following negative cultures in hospitalized patients with pneumonia: rates and outcomes.
Clin Infect Dis 2021 Apr 26;72(8):1314-22. doi: 10.1093/cid/ciaa212..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Pneumonia, Respiratory Conditions, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Inpatient Care
Sabbagh SE, Neely J, Chow A
Risk factors associated with Pneumocystis jirovecii pneumonia in juvenile myositis in North America.
Pneumocystis jirovecii pneumonia (PJP) is associated with significant morbidity and mortality in adult myositis patients; however, there are few studies examining PJP in juvenile myositis [juvenile idiopathic inflammatory myopathy (JIIM)]. The purpose of this study was to determine the risk factors and clinical phenotypes associated with PJP in JIIM. The investigators concluded that having PJP was associated with more immunosuppressive therapy, anti-MDA5 autoantibodies, Asian race and certain clinical features, including digital infarcts, cutaneous ulcerations and interstitial lung disease.
AHRQ-funded; HS000063.
Citation: Sabbagh SE, Neely J, Chow A .
Risk factors associated with Pneumocystis jirovecii pneumonia in juvenile myositis in North America.
Rheumatology 2021 Feb;60(2):829-36. doi: 10.1093/rheumatology/keaa436..
Keywords: Children/Adolescents, Pneumonia, Respiratory Conditions, Risk
Haessler S, Lindenauer PK, Zilberberg MD
Blood cultures versus respiratory cultures: 2 different views of pneumonia.
This study examined characteristics and outcomes of patients with positive cultures for pneumonia by site. The authors compared results from blood and respiratory cultures to see if organisms and resistance patterns differed by site. They studied adult patients discharged from July 2010 to June 2015 with principal diagnoses of pneumonia, respiratory failure, acute respiratory distress syndrome, respiratory arrest, or sepsis with a secondary diagnosis of pneumonia. Out of 138,651 hospitalizations of patients with pneumonia, 9.3% yielded positive cultures with 6438 from respiratory culture and 5992 blood cultures, and 45 both respiratory and blood cultures. Isolates from respiratory samples were often more resistant than were isolates from blood. Patients with positive cultures in both sites had higher case-fatality, longer lengths of stay and higher costs than patients who only had one culture site positive. Among respiratory cultures, the most common pathogens identified were Staphylococcus aureus (34%) and Pseudomonas aeruginosa (17%), whereas blood cultures most commonly grew Streptococcus pneumoniae (33%), followed by S. aureus (22%).
AHRQ-funded; HS024277.
Citation: Haessler S, Lindenauer PK, Zilberberg MD .
Blood cultures versus respiratory cultures: 2 different views of pneumonia.
Clin Infect Dis 2020 Oct 23;71(7):1604-12. doi: 10.1093/cid/ciz1049..
Keywords: Pneumonia, Community-Acquired Infections, Respiratory Conditions, Infectious Diseases
Schimmel JJ, Haessler S, Imrey P
Pneumococcal urinary antigen testing in United States hospitals: a missed opportunity for antimicrobial stewardship.
The Infectious Disease Society of America recommends pneumococcal urinary antigen testing (UAT) when identifying pneumococcal infection would allow for antibiotic de-escalation. However, the frequencies of UAT and subsequent antibiotic de-escalation are unknown. The authors conducted this retrospective cohort study of adult patients admitted with community-acquired or healthcare-associated pneumonia to 170 US hospitals in the Premier database from 2010-2015, to describe variation in UAT use, associations of UAT results with antibiotic de-escalation, and associations of de-escalation with outcomes.
AHRQ-funded; HS024277.
Citation: Schimmel JJ, Haessler S, Imrey P .
Pneumococcal urinary antigen testing in United States hospitals: a missed opportunity for antimicrobial stewardship.
Clin Infect Dis 2020 Sep 12;71(6):1427-34. doi: 10.1093/cid/ciz983..
Keywords: Antimicrobial Stewardship, Community-Acquired Infections, Infectious Diseases, Pneumonia
Strobel RJ, Harrington SD, Hill C
Evaluating the impact of pneumonia prevention recommendations after cardiac surgery.
Pneumonia is the most prevalent healthcare-associated infection after coronary artery bypass grafting (CABG), but the relative effectiveness of strategies to reduce its incidence remains unclear. In this study, the investigators evaluated the relationship between healthcare-associated infection recommendations and risk of pneumonia after CABG. These pneumonia prevention recommendations may serve as effective targets for avoiding postoperative healthcare-associated infections.
AHRQ-funded; HS022535; HS022909.
Citation: Strobel RJ, Harrington SD, Hill C .
Evaluating the impact of pneumonia prevention recommendations after cardiac surgery.
Ann Thorac Surg 2020 Sep;110(3):903-10. doi: 10.1016/j.athoracsur.2019.12.053..
Keywords: Pneumonia, Cardiovascular Conditions, Surgery, Healthcare-Associated Infections (HAIs), Adverse Events, Prevention, Evidence-Based Practice, Guidelines, Risk
Joshi RP, Pejaver V, Hammarlund NE
A predictive tool for identification of SARS-CoV-2 PCR-negative emergency department patients using routine test results.
This retrospective case-control study investigated whether the use of a prediction tool based on complete blood count results and patient sex can better allocate testing for SARS-CoV-2 PCR testing in hospital emergency departments. Participants were emergency department patients who had concurrent complete blood counts and SARS-CoV-2 PCR testing in Northern California, Seattle, Washington, Chicago Illinois, and South Korea. A hypothetical scenario of 1000 patients requiring testing was developed, but in this scenario testing resources are limited to 60% of patients. This tool would allow a 33% increase in properly allocated resources.
AHRQ-funded; HS026385.
Citation: Joshi RP, Pejaver V, Hammarlund NE .
A predictive tool for identification of SARS-CoV-2 PCR-negative emergency department patients using routine test results.
J Clin Virol 2020 Aug;129:104502. doi: 10.1016/j.jcv.2020.104502..
Keywords: Emergency Department, COVID-19, Pneumonia, Respiratory Conditions, Diagnostic Safety and Quality, Clinical Decision Support (CDS)
Thomson J, Hall M, Ambroggio L
Antibiotics for aspiration pneumonia in neurologically impaired children.
The objective of the study was to compare hospital outcomes associated with commonly used antibiotic therapies for aspiration pneumonia in children with neurologic impairment (NI). The investigators concluded that anaerobic therapy appeared to be important in the treatment of aspiration pneumonia in children with NI. They suggested that while Gram-negative coverage alone was associated with worse outcomes, its addition to anaerobic therapy may not yield improved outcomes.
AHRQ-funded; HS025138.
Citation: Thomson J, Hall M, Ambroggio L .
Antibiotics for aspiration pneumonia in neurologically impaired children.
J Hosp Med 2020 Jul;15(7):395-402. doi: 10.12788/jhm.3338..
Keywords: Children/Adolescents, Pneumonia, Respiratory Conditions, Neurological Disorders, Antibiotics, Medication, Outcomes
Higgins TL, Deshpande A, Zilberberg MD
Assessment of the accuracy of using ICD-9 diagnosis codes to identify pneumonia etiology in patients hospitalized with pneumonia.
Researchers assessed the validity of ICD-9 organism-specific administrative codes for pneumonia using microbiological data as the criterion standard, using data from 178 US hospitals in the Premier Healthcare Database. They found that, in this study, ICD-9 codes did not reliably capture pneumonia etiology identified by laboratory testing; because of the high specificities of ICD-9 codes, however, administrative data may be useful in identifying risk factors for resistant organisms. The low sensitivities of the diagnosis codes may limit the validity of organism-specific pneumonia prevalence estimates derived from administrative data.
AHRQ-funded; HS024277, HS025026.
Citation: Higgins TL, Deshpande A, Zilberberg MD .
Assessment of the accuracy of using ICD-9 diagnosis codes to identify pneumonia etiology in patients hospitalized with pneumonia.
JAMA Netw Open 2020 Jul;3(7):e207750. doi: 10.1001/jamanetworkopen.2020.7750.
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Keywords: Pneumonia, Respiratory Conditions, Diagnostic Safety and Quality
Abreo A, Wu P, Donovan BM
Infant respiratory syncytial virus bronchiolitis and subsequent risk of pneumonia, otitis media, and antibiotic utilization.
This study looked at infant respiratory syncytial virus (RSV) bronchiolitis and its association with increased odds of pneumonia, otitis media, and antibiotic utilization in infants 7-12 months. The data suggested the potential value of future RSV vaccination programs on subsequent respiratory health.
AHRQ-funded; HS026395.
Citation: Abreo A, Wu P, Donovan BM .
Infant respiratory syncytial virus bronchiolitis and subsequent risk of pneumonia, otitis media, and antibiotic utilization.
Clin Infect Dis 2020 Jun 24;71(1):211-14. doi: 10.1093/cid/ciz1033..
Keywords: Newborns/Infants, Antibiotics, Medication, Respiratory Conditions, Pneumonia
Zimmerman S, Sloane PD, Ward K
Effectiveness of a mouth care program provided by nursing home staff vs standard care on reducing pneumonia incidence: a cluster randomized trial.
Pneumonia affects more than 250 000 nursing home (NH) residents annually. A strategy to reduce pneumonia is to provide daily mouth care, especially to residents with dementia. The objective of this study was to evaluate the effectiveness of Mouth Care Without a Battle, a program that increases staff knowledge and attitudes regarding oral hygiene, changes mouth care, and improves oral hygiene, in reducing the incidence of pneumonia among NH residents.
AHRQ-funded; HS022298.
Citation: Zimmerman S, Sloane PD, Ward K .
Effectiveness of a mouth care program provided by nursing home staff vs standard care on reducing pneumonia incidence: a cluster randomized trial.
JAMA Netw Open 2020 Jun;3(6):e204321. doi: 10.1001/jamanetworkopen.2020.4321..
Keywords: Pneumonia, Nursing Homes, Long-Term Care, Dental and Oral Health, Prevention, Patient Safety
Wang Y, Eldridge N, Metersky ML
AHRQ Author: Eldridge N, Rodrick D
Association between Medicare expenditures and adverse events for patients with acute myocardial infarction, heart failure, or pneumonia in the United States.
The purpose of this study was to evaluate whether hospital-specific adverse event rates were associated with hospital-specific risk-standardized 30-day episode-of-care Medicare expenditures for fee-for-service patients discharged with acute myocardial infarction (AMI), heart failure (HF), or pneumonia. Investigators concluded that hospitals with high adverse event rates were more likely to have high 30-day episode-of-care Medicare expenditures for patients discharged with AMI, HF, or pneumonia.
AHRQ-authored; AHRQ-funded; 290201200003C.
Citation: Wang Y, Eldridge N, Metersky ML .
Association between Medicare expenditures and adverse events for patients with acute myocardial infarction, heart failure, or pneumonia in the United States.
JAMA Netw Open 2020 Apr;3(4):e202142. doi: 10.1001/jamanetworkopen.2020.2142..
Keywords: Adverse Events, Patient Safety, Heart Disease and Health, Cardiovascular Conditions, Pneumonia, Medicare, Healthcare Costs
Buxbaum JD, Lindenauer PK, Cooke CR
Changes in coding of pneumonia and impact on the hospital readmission reduction program.
Researchers evaluated whether changes in diagnosis assignment explain reductions in 30-day readmission for patients with pneumonia following the Hospital Readmission Reduction Program (HRRP). They conducted a retrospective cohort study of Medicare discharges in HRRP-eligible hospitals; outcomes were 30-day readmission rates for pneumonia under both "narrow" and "broad" definitions that included certain diagnoses of sepsis and aspiration pneumonia. They concluded that changes in the coding of inpatient pneumonia admissions do not explain readmission reduction following the HRRP.
AHRQ-funded; HS000055.
Citation: Buxbaum JD, Lindenauer PK, Cooke CR .
Changes in coding of pneumonia and impact on the hospital readmission reduction program.
Health Serv Res 2019 Dec;54(6):1326-34. doi: 10.1111/1475-6773.13207..
Keywords: Pneumonia, Hospital Readmissions, Medicare, Hospitalization
Popescu I, Sood N, Joshi S
Trends in the use of skilled nursing facility and home health care under the Hospital Readmissions Reduction Program: an interrupted time-series analysis.
Medicare's Hospital Readmission Reduction Program penalizes hospitals with elevated 30-day readmission rates for acute myocardial infarction, heart failure, or pneumonia. The authors investigated if, in order to reduce readmissions, hospitals may have increased referrals to skilled nursing facilities and home health care. They found that hospitals might be shifting to more intensive postacute care to avoid readmissions among seniors with pneumonia. At the same time, penalized hospitals' efforts to prevent readmissions may be keeping higher proportions of their patients in the community.
AHRQ-funded; HS024284; HS025394.
Citation: Popescu I, Sood N, Joshi S .
Trends in the use of skilled nursing facility and home health care under the Hospital Readmissions Reduction Program: an interrupted time-series analysis.
Med Care 2019 Oct;57(10):757-65. doi: 10.1097/mlr.0000000000001184..
Keywords: Home Healthcare, Nursing Homes, Chronic Conditions, Hospital Readmissions, Long-Term Care, Hospitals, Heart Disease and Health, Pneumonia, Cardiovascular Conditions
Obodozie-Ofoegbu OO, Teng C, Mortensen EM
Antipseudomonal monotherapy or combination therapy for older adults with community-onset pneumonia and multidrug-resistant risk factors: a retrospective cohort study.
Infectious Diseases Society of America guidelines recommend empiric antipseudomonal combination therapy when Pseudomonas is suspected. However, combination antipseudomonal therapy is controversial. This population-based retrospective cohort study compared all-cause 30-day mortality in older patients who received antipseudomonal monotherapy (PMT) or antipseudomonal combination therapy (PCT) for the treatment of community-onset pneumonia. The investigators found that older adults who received combination antipseudomonal therapy for community-onset pneumonia fared worse than those who received monotherapy.
AHRQ-funded; HS022418.
Citation: Obodozie-Ofoegbu OO, Teng C, Mortensen EM .
Antipseudomonal monotherapy or combination therapy for older adults with community-onset pneumonia and multidrug-resistant risk factors: a retrospective cohort study.
Am J Infect Control 2019 Sep;47(9):1053-58. doi: 10.1016/j.ajic.2019.02.018..
Keywords: Antibiotics, Community-Acquired Infections, Elderly, Infectious Diseases, Medication, Pneumonia, Risk
Asti L, Bartsch SM, Umscheid CA
The potential economic value of sputum culture use in patients with community-acquired pneumonia and healthcare-associated pneumonia.
Researchers developed a decision model to determine the economic and clinical value of using sputum cultures in the treatment of community-acquired pneumonia (CAP) and healthcare-associated pneumonia (HCAP) from the hospital perspective under various conditions. They found that, overall, obtaining sputum cultures does not provide significant clinical or economic benefits for CAP or HCAP patients; however, it can reduce costs and shorten overall length of stay under some circumstances. They recommended that clinicians consider their local conditions when making decisions about sputum culture use.
AHRQ-funded; HS023317.
Citation: Asti L, Bartsch SM, Umscheid CA .
The potential economic value of sputum culture use in patients with community-acquired pneumonia and healthcare-associated pneumonia.
Clin Microbiol Infect 2019 Aug;25(8):1038.e1-38.e9. doi: 10.1016/j.cmi.2018.11.031..
Keywords: Pneumonia, Community-Acquired Infections, Healthcare-Associated Infections (HAIs), Infectious Diseases, Healthcare Costs, Clinical Decision Support (CDS), Decision Making
Trent SA, Jarou ZJ, Havranek EP
Variation in emergency department adherence to treatment guidelines for inpatient pneumonia and sepsis: a retrospective cohort study.
Evidence-based clinical practice guidelines (CPGs) for the treatment of pneumonia and sepsis have existed for many years with multiple studies suggesting improved patient outcomes. Despite their importance, little is known about variation in emergency department (ED) adherence to these CPGs. The objectives of this study were to estimate variation in ED adherence across CPGs for pneumonia and sepsis and identify patient, provider, and environmental factors associated with adherence.
AHRQ-funded; HS022400.
Citation: Trent SA, Jarou ZJ, Havranek EP .
Variation in emergency department adherence to treatment guidelines for inpatient pneumonia and sepsis: a retrospective cohort study.
Acad Emerg Med 2019 Aug;26(8):908-20. doi: 10.1111/acem.13639.
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Keywords: Emergency Department, Evidence-Based Practice, Guidelines, Inpatient Care, Pneumonia, Sepsis
Gupta NM, Lindenauer PK, Yu PC
Association between alcohol use disorders and outcomes of patients hospitalized with community-acquired pneumonia.
The purpose of this study was to compare the causes, treatment, and outcomes of pneumonia in patients with and without alcohol use disorder (AUD). Results suggest that, compared with hospitalized patients with community-acquired pneumonia but without AUD, those with AUD less often harbor resistant organisms. The authors conclude that higher age-adjusted risk of death among patients with AUD appears to be largely attributable to differences in comorbidities, whereas greater use of health care resources may be attributable to alcohol withdrawal.
AHRQ-funded; HS024277; HS025026.
Citation: Gupta NM, Lindenauer PK, Yu PC .
Association between alcohol use disorders and outcomes of patients hospitalized with community-acquired pneumonia.
JAMA Netw Open 2019 Jun 5;2(6):e195172. doi: 10.1001/jamanetworkopen.2019.5172..
Keywords: Alcohol Use, Community-Acquired Infections, Hospitalization, Outcomes, Pneumonia, Substance Abuse
Colla CH, Lewis VA, Stachowski C
Changes in use of postacute care associated with accountable care organizations in hip fracture, stroke, and pneumonia hospitalized cohorts.
In this study, researchers examined changes in more and less discretionary condition-specific postacute care use associated with Medicare accountable care organization (ACO) implementation. They found that ACOs decreased spending on postacute care by decreasing use of discretionary services. In addition, ACO implementation was associated with reduced length of stay in skilled nursing facilities, while hip fracture patients used institutional postacute settings at higher rates. The authors also observed decreases in spending, readmission days, and mortality among pneumonia patients.
AHRQ-funded; HS024698.
Citation: Colla CH, Lewis VA, Stachowski C .
Changes in use of postacute care associated with accountable care organizations in hip fracture, stroke, and pneumonia hospitalized cohorts.
Med Care 2019 Jun;57(6):444-52. doi: 10.1097/mlr.0000000000001121..
Keywords: Injuries and Wounds, Healthcare Costs, Healthcare Utilization, Hospitalization, Medicare, Pneumonia, Stroke
Glick AF, Tomopoulos S, Fierman AH S, Tomopoulos AH
AHRQ Author: Elixhauser A
Association between outdoor air pollution levels and inpatient outcomes in pediatric pneumonia hospitalizations, 2007 to 2008.
Pneumonia is a leading cause of pediatric admissions. Although air pollutants are associated with poor outcomes, few national studies have examined associations between pollutant levels and inpatient pediatric pneumonia outcomes. In this study, the investigators examined the relationship between ozone (O3) and fine particulate matter with a diameter </=2.5 microm (PM2.5) and outcomes related to disease severity. They concluded that greater levels of O3 and PM2.5 were associated with more severe presentations of pneumonia.
AHRQ-authored
Citation: Glick AF, Tomopoulos S, Fierman AH S, Tomopoulos AH .
Association between outdoor air pollution levels and inpatient outcomes in pediatric pneumonia hospitalizations, 2007 to 2008.
Acad Pediatr 2019 May - Jun;19(4):414-20. doi: 10.1016/j.acap.2018.12.001..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Pneumonia, Respiratory Conditions, Hospitalization, Outcomes
Trent SA, Havranek EP, Ginde AA
Effect of audit and feedback on physician adherence to clinical practice guidelines for pneumonia and sepsis.
This study examined the effect of feedback with blinded peer comparison on emergency physician adherence to guidelines for appropriate antibiotic administration for inpatient pneumonia and completion of the 3-hour Surviving Sepsis Bundle for patients with severe sepsis. A quasi-experiment was conducted with attending physicians randomized into 6 clusters at a single urban safety net hospital. Feedback with blinded peer comparison significantly improved guideline adherence from 52% to 65% with feedback.
AHRQ-funded; HS022400.
Citation: Trent SA, Havranek EP, Ginde AA .
Effect of audit and feedback on physician adherence to clinical practice guidelines for pneumonia and sepsis.
Am J Med Qual 2019 May/Jun;34(3):217-25. doi: 10.1177/1062860618796947..
Keywords: Antibiotics, Emergency Department, Guidelines, Infectious Diseases, Inpatient Care, Medication, Pneumonia, Provider, Provider: Physician, Sepsis
Wiese AD, Griffin MR, Grijalva CG
Impact of pneumococcal conjugate vaccines on hospitalizations for pneumonia in the United States.
In this study, the investigators described the existing evidence for both the direct and indirect impact of Pneumococcal conjugate vaccines (PCVs) on pneumonia among children and adults in the US since PCV introduction. The introduction of PCVs into the US routine infant vaccination schedule led to important reductions in the burden of invasive pneumococcal diseases and non-invasive pneumonia among vaccinated and unvaccinated populations. The impact of direct vaccination of older adults in the US since 2014, though difficult to quantify, is currently being evaluated.
AHRQ-funded; HS022342.
Citation: Wiese AD, Griffin MR, Grijalva CG .
Impact of pneumococcal conjugate vaccines on hospitalizations for pneumonia in the United States.
Expert Rev Vaccines 2019 Apr;18(4):327-41. doi: 10.1080/14760584.2019.1582337..
Keywords: Vaccination, Pneumonia, Respiratory Conditions, Hospitalization, Prevention
Leyenaar JK, Andrews CB, Tyksinski ER
Facilitators of interdepartmental quality improvement: a mixed-methods analysis of a collaborative to improve pediatric community-acquired pneumonia management.
This study examined the relationship between emergency room (ER) physicians and hospital pediatricians in the use of narrow-spectrum antibiotics to treat children hospitalized with pneumonia. There were eight inter-related domains that were identified that contribute to successful quality improvement efforts. These domains include hospital leadership and support; quality improvement champions, and interdepartmental relationships.
AHRQ-funded; HS024133; HS024554.
Citation: Leyenaar JK, Andrews CB, Tyksinski ER .
Facilitators of interdepartmental quality improvement: a mixed-methods analysis of a collaborative to improve pediatric community-acquired pneumonia management.
BMJ Qual Saf 2019 Mar;28(3):215-22. doi: 10.1136/bmjqs-2018-008065..
Keywords: Children/Adolescents, Community-Acquired Infections, Emergency Department, Pneumonia, Quality of Care, Quality Improvement