Best Practices - PNE

The Centers for Medicare & Medicaid Service (CMS) and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) together developed core measures to be used to increase quality of care for patients with pneumonia. The measures related to treatment to pneumonia are:

• Measuring the oxygen blood levels
• Performing the recommended blood test
• Giving antibiotics in a timely fashion
• Providing advice/counseling on how to stop smoking
• Before discharge, screening and vaccinating against pneumonia

The definition of and rationale for the selection of these measures is found in the document "Current Specification Manual for National Hospital Quality Measures," which can be found on the Joint Commission's website: http://www.jointcommission.org/PerformanceMeasurement/
PerformanceMeasurement/Current+NHQM+Manual.htm

Practitioners should stay up-to-date on the current care practices to ensure they provide the best care for their patients. The following example documents were created to assist practitioners to provide adequate care:

• Acumentra Health has an online resource page about immunizations. The webpage provides free downloadable documents including an immunization assessment form and pre-printed orders for immunization. Find the resource page at: http://www.acumentra.org/healthcare-settings/physician-offices/immunizations.htm
• The Pneumonia Severity Index Calculator, designed for personal digital assistants such as Palm Pilots, is a tool that can be downloaded from the website of the Agency for Healthcare Research and Quality. Practitioners use the tool to help determine treatment for patients with pneumonia. The software for the tool is available at the following link: http://pda.ahrq.gov/clinic/psi/psi.htm
• The Immunizer's Question and Answer Guide to Medicare Coverage of Influenza and Pneumococcal Vaccinations from the Centers for Medicare & Medicaid Services addresses frequently asked questions about administering the influenza and pneumococcal vaccines. The document is available at the following link: http://www.cms.hhs.gov/AdultImmunizations/Downloads/0506qanda033006.pdf

Practitioners can assist patients with understanding disease and the procedures and care for pneumonia. A variety of media are available including:

• A fact sheet about pneumonia from the American Lung Association is available at: http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=35692
• The Mayo Clinic describes the symptoms, causes, and treatment of pneumonia for a non-technical audience in an article located in the Infectious Disease Center area of its website at: http://www.mayoclinic.com/invoke.cfm?objectid=101586DD-4780-4B53-9AA9C9010C842DAA&dsection=1
• The Maryland Health Care Commission Hospital Guide website contains descriptive information about pneumonia on the following page:
  http://mhcc.maryland.gov/consumerinfo/hospitalguide/
  practitioners/technical_information/pne_information.html
• The American Lung Association provides a free online smoking cessation program that uses multiple modules to help a patient give up smoking. The program, called Freedom From Smoking® Online, is accessed through their website, by clicking on the FFS Online Program link, at: http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=33484

This website provides details on the performance for all Maryland Hospitals for the measures identified previously on this page. You should become familiar with this performance information to be able to answer questions from your patients regarding Hospital performance and the core measure set for patients with pneumonia.