Improved treatment of community-acquired pneumonia through tailored interventions: Results from a controlled, multicentre quality improvement project

Publikation: Bidrag til tidsskriftTidsskriftartikelfagfællebedømt

Standard

Improved treatment of community-acquired pneumonia through tailored interventions : Results from a controlled, multicentre quality improvement project. / Fally, Markus; von Plessen, Christian; Anhøj, Jacob; Benfield, Thomas; Tarp, Britta; Clausen, Lise Notander; Kolte, Lilian; Diernaes, Emma; Molzen, Line; Seerup, Regitze; Israelsen, Simone; Hellesøe, Anne-Marie Blok; Ravn, Pernille.

I: PLoS ONE, Bind 15, Nr. 6, e0234308, 2020.

Publikation: Bidrag til tidsskriftTidsskriftartikelfagfællebedømt

Harvard

Fally, M, von Plessen, C, Anhøj, J, Benfield, T, Tarp, B, Clausen, LN, Kolte, L, Diernaes, E, Molzen, L, Seerup, R, Israelsen, S, Hellesøe, A-MB & Ravn, P 2020, 'Improved treatment of community-acquired pneumonia through tailored interventions: Results from a controlled, multicentre quality improvement project', PLoS ONE, bind 15, nr. 6, e0234308. https://doi.org/10.1371/journal.pone.0234308

APA

Fally, M., von Plessen, C., Anhøj, J., Benfield, T., Tarp, B., Clausen, L. N., Kolte, L., Diernaes, E., Molzen, L., Seerup, R., Israelsen, S., Hellesøe, A-M. B., & Ravn, P. (2020). Improved treatment of community-acquired pneumonia through tailored interventions: Results from a controlled, multicentre quality improvement project. PLoS ONE, 15(6), [e0234308]. https://doi.org/10.1371/journal.pone.0234308

Vancouver

Fally M, von Plessen C, Anhøj J, Benfield T, Tarp B, Clausen LN o.a. Improved treatment of community-acquired pneumonia through tailored interventions: Results from a controlled, multicentre quality improvement project. PLoS ONE. 2020;15(6). e0234308. https://doi.org/10.1371/journal.pone.0234308

Author

Fally, Markus ; von Plessen, Christian ; Anhøj, Jacob ; Benfield, Thomas ; Tarp, Britta ; Clausen, Lise Notander ; Kolte, Lilian ; Diernaes, Emma ; Molzen, Line ; Seerup, Regitze ; Israelsen, Simone ; Hellesøe, Anne-Marie Blok ; Ravn, Pernille. / Improved treatment of community-acquired pneumonia through tailored interventions : Results from a controlled, multicentre quality improvement project. I: PLoS ONE. 2020 ; Bind 15, Nr. 6.

Bibtex

@article{d670beee039446bcb2d7cf070918cfa3,
title = "Improved treatment of community-acquired pneumonia through tailored interventions: Results from a controlled, multicentre quality improvement project",
abstract = "BACKGROUND: Community-acquired pneumonia (CAP) is one of the leading causes of healthcare utilisation and death worldwide. Treatment according to evidence-based clinical guidelines can reduce mortality, antibiotic exposure and length of hospital stay related to CAP.LOCAL PROBLEM: Several studies, including a pilot study from one of our sites, indicate that physicians show a low grade of guideline adherence when managing patients with CAP.METHODS: To improve the guideline-based treatment of patients with CAP admitted to hospital, we designed a quality improvement study. Four process indicators were combined in a CAP care bundle: chest X-ray, CURB-65 severity score, lower respiratory tract samples and antibiotics within 8 hours from admission. After a 4-month baseline period, we applied multiple interventions at three hospitals during 8 months. Progression in our process indicators was measured continuously and compared with a control site without interventions. After the 8-month intervention period, we continued with a 4-month follow-up period to assess the sustainability of the improvements.RESULTS: The care bundle utilisation rate within 8 hours increased from 11% at baseline to 41% in the follow-up period at the intervention sites, whereas it remained below 3% at the control site. The most considerable improvements have been observed regarding documentation of CURB-65 (34% at baseline, 68% at follow-up) and the collection of lower respiratory tract samples (43% at baseline, 63% at follow-up).CONCLUSION: Our study has demonstrated poor adherence to CAP guidelines at all sites at baseline. After implementing multiple tailored interventions, guideline adherence increased substantially. In conclusion, we recommend that CAP guidelines should be actively adapted in order to be followed in a daily routine.",
keywords = "Aged, Aged, 80 and over, Anti-Bacterial Agents/therapeutic use, Community-Acquired Infections/diagnostic imaging, Denmark, Evidence-Based Medicine, Female, Guideline Adherence, Humans, Male, Middle Aged, Patient Care Bundles/standards, Pilot Projects, Pneumonia/diagnostic imaging, Prospective Studies, Quality Improvement, Severity of Illness Index",
author = "Markus Fally and {von Plessen}, Christian and Jacob Anh{\o}j and Thomas Benfield and Britta Tarp and Clausen, {Lise Notander} and Lilian Kolte and Emma Diernaes and Line Molzen and Regitze Seerup and Simone Israelsen and Helles{\o}e, {Anne-Marie Blok} and Pernille Ravn",
year = "2020",
doi = "10.1371/journal.pone.0234308",
language = "English",
volume = "15",
journal = "PLoS ONE",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "6",

}

RIS

TY - JOUR

T1 - Improved treatment of community-acquired pneumonia through tailored interventions

T2 - Results from a controlled, multicentre quality improvement project

AU - Fally, Markus

AU - von Plessen, Christian

AU - Anhøj, Jacob

AU - Benfield, Thomas

AU - Tarp, Britta

AU - Clausen, Lise Notander

AU - Kolte, Lilian

AU - Diernaes, Emma

AU - Molzen, Line

AU - Seerup, Regitze

AU - Israelsen, Simone

AU - Hellesøe, Anne-Marie Blok

AU - Ravn, Pernille

PY - 2020

Y1 - 2020

N2 - BACKGROUND: Community-acquired pneumonia (CAP) is one of the leading causes of healthcare utilisation and death worldwide. Treatment according to evidence-based clinical guidelines can reduce mortality, antibiotic exposure and length of hospital stay related to CAP.LOCAL PROBLEM: Several studies, including a pilot study from one of our sites, indicate that physicians show a low grade of guideline adherence when managing patients with CAP.METHODS: To improve the guideline-based treatment of patients with CAP admitted to hospital, we designed a quality improvement study. Four process indicators were combined in a CAP care bundle: chest X-ray, CURB-65 severity score, lower respiratory tract samples and antibiotics within 8 hours from admission. After a 4-month baseline period, we applied multiple interventions at three hospitals during 8 months. Progression in our process indicators was measured continuously and compared with a control site without interventions. After the 8-month intervention period, we continued with a 4-month follow-up period to assess the sustainability of the improvements.RESULTS: The care bundle utilisation rate within 8 hours increased from 11% at baseline to 41% in the follow-up period at the intervention sites, whereas it remained below 3% at the control site. The most considerable improvements have been observed regarding documentation of CURB-65 (34% at baseline, 68% at follow-up) and the collection of lower respiratory tract samples (43% at baseline, 63% at follow-up).CONCLUSION: Our study has demonstrated poor adherence to CAP guidelines at all sites at baseline. After implementing multiple tailored interventions, guideline adherence increased substantially. In conclusion, we recommend that CAP guidelines should be actively adapted in order to be followed in a daily routine.

AB - BACKGROUND: Community-acquired pneumonia (CAP) is one of the leading causes of healthcare utilisation and death worldwide. Treatment according to evidence-based clinical guidelines can reduce mortality, antibiotic exposure and length of hospital stay related to CAP.LOCAL PROBLEM: Several studies, including a pilot study from one of our sites, indicate that physicians show a low grade of guideline adherence when managing patients with CAP.METHODS: To improve the guideline-based treatment of patients with CAP admitted to hospital, we designed a quality improvement study. Four process indicators were combined in a CAP care bundle: chest X-ray, CURB-65 severity score, lower respiratory tract samples and antibiotics within 8 hours from admission. After a 4-month baseline period, we applied multiple interventions at three hospitals during 8 months. Progression in our process indicators was measured continuously and compared with a control site without interventions. After the 8-month intervention period, we continued with a 4-month follow-up period to assess the sustainability of the improvements.RESULTS: The care bundle utilisation rate within 8 hours increased from 11% at baseline to 41% in the follow-up period at the intervention sites, whereas it remained below 3% at the control site. The most considerable improvements have been observed regarding documentation of CURB-65 (34% at baseline, 68% at follow-up) and the collection of lower respiratory tract samples (43% at baseline, 63% at follow-up).CONCLUSION: Our study has demonstrated poor adherence to CAP guidelines at all sites at baseline. After implementing multiple tailored interventions, guideline adherence increased substantially. In conclusion, we recommend that CAP guidelines should be actively adapted in order to be followed in a daily routine.

KW - Aged

KW - Aged, 80 and over

KW - Anti-Bacterial Agents/therapeutic use

KW - Community-Acquired Infections/diagnostic imaging

KW - Denmark

KW - Evidence-Based Medicine

KW - Female

KW - Guideline Adherence

KW - Humans

KW - Male

KW - Middle Aged

KW - Patient Care Bundles/standards

KW - Pilot Projects

KW - Pneumonia/diagnostic imaging

KW - Prospective Studies

KW - Quality Improvement

KW - Severity of Illness Index

U2 - 10.1371/journal.pone.0234308

DO - 10.1371/journal.pone.0234308

M3 - Journal article

C2 - 32525882

VL - 15

JO - PLoS ONE

JF - PLoS ONE

SN - 1932-6203

IS - 6

M1 - e0234308

ER -

ID: 257027676