Michael Klompas, MD, MPH; Richard Platt, MD, MSc
Acknowledgment: The authors thank Julia Przedworski for her invaluable assistance in researching state regulatory requirements for reporting ventilator-associated pneumonia.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Michael Klompas, MD, MPH, Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, 133 Brookline Avenue, 6th Floor, Boston, MA 02215.
Current Author Addresses: Drs. Klompas and Platt: Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, 133 Brookline Avenue, 6th Floor, Boston, MA 02215.
Legislators, payers, and quality-of-care advocates across the United States are considering requiring hospitals to report ventilator-associated pneumonia rates as a way to benchmark and reward quality of care. Accurate diagnosis of ventilator-associated pneumonia, however, is notoriously difficult because several common complications of critical care can mimic the clinical appearance of ventilator-associated pneumonia. The challenge is compounded by substantial subjectivity inherent in the current surveillance definition. These sources of variability make ventilator-associated pneumonia rates difficult to acquire, interpret, and compare both within and among institutions. Ventilator-associated pneumonia should be excluded from compulsory reporting initiatives until we develop and validate more objective outcome measures that meaningfully reflect quality of care for ventilated patients.
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Klompas M, Platt R. Ventilator-Associated Pneumonia—The Wrong Quality Measure for Benchmarking. Ann Intern Med. 2007;147:803–805. doi: 10.7326/0003-4819-147-11-200712040-00013
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Published: Ann Intern Med. 2007;147(11):803-805.
Infectious Disease, Mechanical Ventilation, Pneumonia, Pulmonary/Critical Care.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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