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Pneumonia


Pneumonia is an infection of the lungs. These indicators apply to pneumonia that started prior to hospital admission. (The Infection Control section covers pneumonia that started while in the hospital.) Although children also can develop pneumonia, current nationally endorsed indicators apply only to persons age 18 or older. These indicators examine the initial care of pneumonia patients, and the extent to which the hospital staff help the patient prevent future lung problems. Norton Healthcare performance represents the performance of all the hospitals combined.

Pneumonia treatment - percent of pneumonia patients
This indicator monitors the composite score on all 3 Pneumonia accountability measures. Accountability measures are quality measures that meet four criteria designed to identify measures that produce the greatest positive impact on patient outcomes when hospitals demonstrate improvement: Research (strong scientific evidence exists demonstrating that compliance with a given process of care improves health outcomes), Proximity (the process being measured is closely connected to the outcome it impacts; there are relatively few clinical processes that occur after the one that is measured and before the improved outcome occurs), Accuracy (the measure accurately assesses whether the evidence-based process has actually been provided), and Adverse Effects (the measure construct is designed to minimize or eliminate unintended adverse effects). Elements include pn3b, pn6a, pn6b. Accountability measures have been integrated into the information reported on Quality Check. However, the categorizati on of the measures into accountability and non-accountability measures will not affect individual measure information reported on Quality Check.(JC) PN accountability measures' composite high 96 # 87 100Quality Ribbon # 96 94 95
Number of pneumonia patients per 100, who received initial antibiotic consistent with current guideline recommendations during the first 24 hours of their hospitalization. Recommended antibiotics are most effective in pneumonia patients. Includes inpatients discharged with a principal diagnosis of pneumonia. Excludes patients transferred from another hospital, patients who had no working diagnosis of pneumonia at time of admission, patients admitted for comfort measures only, patients who did not receive antibiotics during hospitalization or within 36 hours after hospital arrival, those who are immunocompromised, patients with Healthcare Associated Pneumonia and patients who had no chest x-ray or CT scan that indicated positive infiltrate within 24 hours prior to hospital arrival or anytime during hospitalization.(NQF PN 25 / CMS PN 6) given recommended antibiotic high 95 # # 100Quality Ribbon # 95 94 95
Other pneumonia treatment - percent of pneumonia patients
Number of pneumonia patients per 100, who transferred or where admitted to the ICU within 24 hours of hospital arrival, who had blood cultures performed within 24 hours prior to or 24 hours after hospital arrival. Blood cultures provide more useful information about treatment, if collected before antibiotics are given. Includes inpatients discharged with a principal diagnosis of pneumonia, and patients transferred or admitted to the ICU within 24 hours of hospital arrival. Excludes patients transferred from another hospital, patients who had no working diagnosis of pneumonia at time of admission, patients admitted for comfort measures only, patients not transferred or admitted to the ICU within 24 hours of hospital arrival and patients who had no chest x-ray or CT scan that indicated positive infiltrate within 24 hours prior to hospital arrival or anytime during hospitalization.(CMS PN 3a) in ICU given blood cultures w/in 24 hr of arrival high 100Quality Ribbon # # # # 100 98 98
Number of ICU pneumonia patients who received initial antibiotic regimen consistent with current guidelines during the first 24 hours of their hospitalization. Includes inpatients discharged with a principal diagnosis of pneumonia. Excludes patients transferred from another hospital, patients who had no working diagnosis of pneumonia at time of admission, patients admitted for comfort measures only, patients who did not receive antibiotics during hospitalization or within 36 hours after hospital arrival, those who are immunocompromised, patients with Healthcare Associated Pneumonia and patients who had no chest x-ray or CT scan that indicated positive infiltrate within 24 hours prior to hospital arrival or anytime during hospitalization.(JC PN6a) in ICU given recommended antibiotic high # # # # # # 88 92
Number of non-ICU pneumonia patients who received initial antibiotic regimen consistent with current guidelines during the first 24 hours of their hospitalization. Includes inpatients discharged with a principal diagnosis of pneumonia. Excludes patients transferred from another hospital, patients who had no working diagnosis of pneumonia at time of admission, patients admitted for comfort measures only, patients who did not receive antibiotics during hospitalization or within 36 hours after hospital arrival, those who are immunocompromised, patients with Healthcare Associated Pneumonia and patients who had no chest x-ray or CT scan that indicated positive infiltrate within 24 hours prior to hospital arrival or anytime during hospitalization.(JC PN6b) not in ICU given recommended antibiotic high 94 # # 100Quality Ribbon # 94 96 97
Pneumonia mortality - percent of hospitalized pneumonia patients
Number of pneumonia patients per 100, who died in the hospital. Risk-adjusted using patient age, severity of illness, and risk of mortality (APR-DRG version 20). Includes inpatients 18 years and older discharged with a principal diagnosis of pneumonia. Excludes patients with missing discharge dispositions or patients transferred to an acute care hospital.(AHRQ IQI 20) who die (AHRQ risk-adjusted) low 1.9 1.7 1.9 0.7   1.7   4.1
Number of pneumonia patients per 100, who died of any cause within 30 days of admission. Includes Medicare patients who are 65 years of age and older and discharged with a principal diagnosis of pneumonia. Excludes patients discharged alive with length of stay less than 1 day/AMA, and patients not enrolled in Medicare for the past 12 months. who die of any cause w/in 30 days (adj) low 10.6 10.6 10.6 10.6   10.6   11.9
Pneumonia readmission - percent of Pneumonia patients
Number of pneumonia patients per 100, who were readmitted to any hospital for any cause within 30 days of discharge. Includes Medicare patients who are 65 years of age and older who were discharged with a principal diagnosis of pneumonia. Excludes patients who died, and patients not enrolled in Medicare for the past 12 months. who are readmitted for any cause w/in 30 days (adj) low 18.3 18.3 18.3 18.3   18.3   17.6

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