[Community acquired pneumonia in the emergence department--do standardized care bundles improve quality of care?].
Community acquired pneumonia (CAP) is associated with high in-hospital mortality. The initial correct diagnosis, risk assessment and initiation of treatment are responsibilities of the emergency department (ED). In Germany, emergency medicine is not well established nationwide and organized in a very heterogeneous manner. Therefore, systematic approaches to improve quality of care are scarce and standardisations of processes are required. Standardized care bundles for CAP identify patients at increased risk for an adverse outcome. Early detection of CAP in the emergency department is essential for initiating timely and appropriate treatment. As part of the nationwide CAP quality improvement program we use CRB-65 for initial risk stratification in the ED. In own investigations we demonstrated that implementation of systematic guideline based care bundles for pneumonia significantly improves quality of care in the ED subsequently leading to decreased mortality during hospitalization. Early standardized care bundles in the ED reduce length-of-stay in the hospital and the intensive care unit. Furthermore, those strategies are accompanied with an improvement of economic characteristics.
Marcus
M
Hortmann
Hans Jürgen
HJ
Heppner
Katrin
K
Singler
Goetz
G
Geldner
Michael
M
Christ
D015415:Biomarkers; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D003422:Critical Care; D004632:Emergency Medical Services / Q000379:methods*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D064872:Patient Care Bundles; D011014:Pneumonia / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality / Q000628:therapy*; D018570:Risk Assessment
D015415:Biomarkers