The Unintended, Negative Consequences of the Door-to-Antibiotic Measure for Pneumonia
Authors: Nathan C. Dean
Journal: Annals of Internal Medicine (2009)

Letters3 February 2009The Unintended, Negative Consequences of the Door-to-Antibiotic Measure for PneumoniaNathan C. Dean, MDNathan C. Dean, MDFrom Intermountain Health Care, Murray, UT 84107.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-150-3-200902030-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I read with interest the recent article by Wachter and colleagues (1). An additional consequence of policies from the Centers for Medicare & Medicaid Services (CMS) has been the disruption of local pneumonia guideline processes. The 2007 American Thoracic Society–Infectious Disease Society of America pneumonia guideline (2) recommended that “locally adapted guidelines should be implemented to improve process of care variables and relevant clinical outcomes.” In addition, “CAP [community-acquired pneumonia] guidelines should address a comprehensive set of elements in the process of care, rather than a single element in isolation.”A guideline was implemented in the Intermountain ...References1. Wachter RM, Flanders SA, Fee C, Pronovost PJ. Public reporting of antibiotic timing in patients with pneumonia: lessons from a flawed performance measure. Ann Intern Med. 2008;149:29-32. [PMID: 18591635] LinkGoogle Scholar2. Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC, et al; Infectious Diseases Society of America. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007;44 Suppl 2 S27-72. [PMID: 17278083] CrossrefMedlineGoogle Scholar3. Suchyta MR, Dean NC, Narus S, Hadlock CJ. Effects of a practice guideline for community-acquired pneumonia in an outpatient setting. Am J Med. 2001;110:306-9. [PMID: 11239849] CrossrefMedlineGoogle Scholar4. Dean NC, Bateman KA, Donnelly SM, Silver MP, Snow GL, Hale D. Improved clinical outcomes with utilization of a community-acquired pneumonia guideline. Chest. 2006;130:794-9. [PMID: 16963677] CrossrefMedlineGoogle Scholar5. Porter ME, Teisberg EO. Redefining Health Care. Boston: Harvard Business School Pr; 2006:263. Google Scholar Author, Article, and Disclosure InformationAffiliations: From Intermountain Health Care, Murray, UT 84107.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPublic Reporting of Antibiotic Timing in Patients with Pneumonia: Lessons from a Flawed Performance Measure Robert M. Wachter , Scott A. Flanders , Christopher Fee , and Peter J. Pronovost The Unintended, Negative Consequences of the Door-to-Antibiotic Measure for Pneumonia Manfred Gogol The Unintended, Negative Consequences of the Door-to-Antibiotic Measure for Pneumonia Nadine Srouji The Unintended, Negative Consequences of the Door-to-Antibiotic Measure for Pneumonia Robert M. Wachter , Christopher Fee , and Scott A. Flanders Metrics 3 February 2009Volume 150, Issue 3Page: 219KeywordsAntibioticsConflicts of interestDeath ratesHealth careHealth care policyMedicarePneumonia ePublished: 3 February 2009 Issue Published: 3 February 2009 CopyrightCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...