Pneumonia mortality reduction and quality improvement in a community hospital.

Rather than explain adverse results on the basis of flawed data, a physician-directed quality improvement program was initiated to improve the delivery of care to patients admitted to Forbes Health System (Monroeville, Penn) with community-acquired pneumonia. Following the introduction of standardized physician orders and modification and elimination of inefficient processes of care, the mortality rate for this infection decreased from 10.2% to 6.8%. This initial exposure to the quality improvement process led to the participation of the medical staff in other related clinical and support service initiatives. In addition, Forbes and its clinical partners are now better positioned to respond to increasing government, managed care, and consumer inquiries relating to cost and quality outcomes. Finally, this positive experience facilitated the organization's transition from inspection-based quality assessment to quality improvement activities, which should assist in efforts to meet or exceed new accreditation standards.