Guidelines and quality for community-acquired pneumonia: measures from the Joint Commission and the Centers for Medicare and Medicaid Services

Abstract

Purpose: The rationales for and recent updates on quality measures for the treatment of community-acquired pneumonia (CAP) are reviewed.

Summary: CAP continues to be among the most common causes of emergency department visits, hospitalization, and death in the United States. The Joint Commission of Accredited Health Care Organizations in conjunction with the Centers for Medicare and Medicaid Services (CMS) and the Infectious Diseases Society of America have published seven quality measures designed to improve the overall treatment of CAP. To encourage and enforce compliance with the measures, adherence is publicly reported, and several measures are used in the CMS pay-per-performance initiative. The quality measures are oxygen assessment, pneumococcal conjugate vaccination, blood cultures, adult smoking cessation advice/counseling, antimicrobial timing, initial antimicrobial selection in immunocompetent intensive care unit (ICU) and non-ICU patients, and influenza vaccination.

Conclusion: The Joint Commission, CMS, and IDSA guidelines for the management of patients with CAP address basic aspects of preventive care and treatment for CAP. The guidelines emphasize the importance of vaccination as well as the need for appropriate and timely antimicrobial therapy. Adherence to guidelines is associated with improved patient outcomes, and compliance is being enforced by public reporting and pay-per-performance measures.