title: Assessing quality indicators for pediatric community-acquired pneumonia.
abstract: To assess applicability of adult quality indicators in the management of pediatric community-acquired pneumonia (CAP), a retrospective cohort study of children admitted with CAP was conducted. The primary outcome was achievement of recommended adult quality indicators. Associations between quality indicators and clinical outcomes were assessed. Most children had rapid oxygenation assessment (97%) and blood culture before antibiotics (98%). Antibiotic timing and selection indicators were met less frequently. The only quality indicator associated with time to stability or length of stay was antibiotic timing; each additional hour until antibiotic administration was associated with a 3% increase in time to clinical stability (P = .001) and a 3% increase in length of stay (P = .002). Recommended adult quality indicators are not achieved by many children with CAP. Time to antibiotic administration is predictive of more rapid stabilization and reduced length of stay. Modification of several other adult measures would improve their applicability for pediatric CAP.
authors.affiliation: Division of Infectious Diseases, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts 02115, USA. thomas.sandora@childrens.harvard.edu
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Sandora
authors.forename: Rishi
authors.initials: R
authors.lastname: Desai
authors.forename: Benjamin A
authors.initials: BA
authors.lastname: Miko
authors.forename: Marvin B
authors.initials: MB
authors.lastname: Harper
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D017714:Community-Acquired Infections / Q000628:therapy; D006776:Hospitals, Pediatric / Q000592:standards; D006801:Humans; D007223:Infant; D017063:Outcome Assessment, Health Care / Q000592:standards; D011014:Pneumonia / Q000175:diagnosis / Q000628:therapy*; D019984:Quality Indicators, Health Care / Q000592:standards*; D012189:Retrospective Studies; D014481:United States