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Standardization of a community-acquired pneumonia order set within five regional hospitals. J Pharm Soc Wis. Nagy MW, Wang J, Siodlak MM, Shah N, Carrell LR. Standardization of a community-acquired pneumonia order set within five regional hospitals. J Pharm Soc Wis. 2016;19(6):36-40

Date

12/01/2016

Abstract

Objective: To measure the impact of standardizing emergency department (ED) order sets for community-acquired pneumonia from multiple hospitals within a single health system on clinical and compliance outcomes.

Methods: A quasi-experimental, retrospective analysis of patients with a primary diagnosis of community-acquired pneumonia before and after implementation of a standardized order set. The primary outcome was patient length of stay, with secondary clinical outcomes of 30-day all-cause mortality and 30-day readmission rate. Core compliance outcomes from The Joint Commission and Infectious Diseases Society of America were analyzed by the percentages of patients receiving influenza and pneumococcal pneumonia vaccinations and having blood cultures obtained in the ED.

Results: There was a non-significant decrease of 0.23 days in the length of stay (p=0.217). The 30-day all-cause mortality decreased by 5.3% (p=0.060), while there was a negligible increase of 1.1% in 30-day readmission rate (p=0.578).

Statistically significant increases were found in the proportion of influenza and pneumococcal vaccinations given during admission and cultures obtained in the ED: 25.1% (p<0.0001), 19.1% (p<0.0001), and 6.6% (p=0.025), respectively.

Conclusion: Streamlining an order set for a health system through careful consideration of current literature and clinical practice guidelines has unclear impact on clinical outcomes, but it significantly improves core compliance outcomes.

Author List

Nagy MW, Wang J, Siodlak MM, Shah N, Carrell LR.

Author

Michael W. Nagy PharmD Assistant Professor in the School of Pharmacy Administration department at Medical College of Wisconsin