Advancing Quality NHS Advancing Quality Alliance

Pneumonia

Pneumonia is usually caused by a viral or bacterial infection. The infection results in the lungs becoming inflamed. Advancing Quality measures the treatment of patients who are admitted to hospital with Pneumonia (we refer to this as community acquired pneumonia).

Symptoms of pneumonia can include a cough, chest pain, fever, and difficulty breathing. Pneumonia presumed to be bacterial is treated with antibiotics. If the pneumonia is severe it results in a patient being admitted to hospital.

Through research, clinical input and clinical guidelines Advancing Quality has developed five measures that, when applied at the appropriate time, can greatly increase the outcomes for patients. Advancing Quality uses these measures to monitor the quality of care given to patients across the North West with the aim of improving standards and reducing variation in care.


Measures

1. Assessment of oxygen levels in blood

Measuring the levels of oxygen in your blood allows medical staff to assess the severity of your pneumonia and if you require oxygen treatment. From October 2015 clinical experts in the North West agreed that patients should receive this measure within 4 hours of arrival at hospital

2. Appropriate antibiotics are selected

It is important that you receive the right antibiotic for you and your specific condition.

3. Blood Cultures Taken in Accident and Emergency (Retired Y6)

Having your blood cultures taken is an important part of the diagnostic process. This measure was retired at the end of period 6 due to the variation in policies and processes within hospitals.

4. Antibiotics within six hours of arriving at hospital (Retired Oct 2015)

The timing of antibiotics is very important and for pneumonia patients it is most effective if administered within the first six hours after hospital arrival. In October 2015 this measure was retired.  Clinical experts in the North West followed advice from the NICE 2014 guidelines and adjusted the measure to be antibiotics within 4 hours of arrival.  

define:

The National Institute for Health and Care Excellence (NICE) provides national guidance to improve health and social care.

5. Help to stop smoking (Retired Oct 2015)

If you are a smoker you will be offered support and advice to stop smoking. Stopping smoking reduces the chance of further health problems. In October 2015 clinical experts in the North West decided that progress in smoking cessation and the number of patients that have quit smoking meant the measure was only applicable to a small minority, therefore the measure was retired.

6. Assessment of severity of Pneumonia (Introduced Y4)

A measure called CURB-65 will assess the severity of your pneumonia and ultimately the most appropriate treatment plan care in hospital.

define:

CURB-65, also known as the CURB criteria, is a clinical prediction rule that has been validated for predicting mortality in community-acquired pneumonia and infection of any site. The CURB-65 is based on the earlier CURB score and is recommended by the British Thoracic Society for the assessment of severity of pneumonia.
 

7. Chest X-ray within four hours of arriving at hospital (Introduced Oct 2015)

NICE 2014 recommend that organisations implement processes to allow diagnosis (including x-rays) and treatment of community acquired pneumonia within 4 hours of presentation to hospital. 'A chest X-ray can show how much your lungs are affected. It can also help the doctor distinguish between pneumonia and other chest infections'
NHS Choices

define:

The National Institute for Health and Care Excellence (NICE) provides national guidance to improve health and social care
 

8. Antibiotics within four hours of arriving at hospital (Introduced Oct 2015)

The timing of antibiotics is very important and for pneumonia patients NICE (2014) recommends that antibiotic therapy is commenced as soon as possible after diagnosis and certainly within 4 hours

define:

The National Institute for Health and Care Excellence (NICE) provides national guidence to improve health and social care.
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