Implementing CAP guidelines: impediments and opportunities

The implementation of guidelines for treatment of Community-Acquired Pneumonia (CAP) has been proposed as a quality improvement and cost-saving strategy, though the effectiveness of several recommendations has yet to be confirmed through clinical trials. We sought to analyze the development and implementation of guidelines at our hospital, and to identify particular successes and impediments.

Date sources included the Web sites of the Joint Commission on Accreditation of Healthcare Organizations, the Infectious Disease Society of America, and the American Thoracic Society. References from their guidelines were reviewed, and further citations were obtained using Ovid software to search for references within the last 15 years using "pneumonia guideline," "pneumococcal vaccination," and other relevant search terms. Our own hospital data was compiled, analyzed, and presented using Excel software.

Significant improvement was seen during the 2-year study period when CAP guidelines were implemented at our hospital. However, we also identified several impediments, which will require further attention to achieve our quality improvement goals.

Our implementation of CAP guidelines was challenging but overall instructive and contributory to patient care. We review further areas for improvement.