TY - JOUR T1 - Sustainability of healthcare improvements for patients admitted with community-acquired pneumonia: follow-up data from a quality improvement project JF - BMJ Open Quality JO - BMJ Open Qual DO - 10.1136/bmjoq-2021-001737 VL - 11 IS - 2 SP - e001737 AU - Markus Fally AU - Maria Elizabeth Engel Møller AU - Jacob Anhøj AU - Britta Tarp AU - Thomas Benfield AU - Pernille Ravn Y1 - 2022/05/01 UR - http://bmjopenquality.bmj.com/content/11/2/e001737.abstract N2 - Community-acquired pneumonia (CAP) is common and associated with high mortality and healthcare expenses.1 As in other diseases, adherence to management recommendations showed to be variable in CAP, due to multiple factors including lack of knowledge, personal beliefs and inefficient healthcare processes.2 3To increase adherence to management recommendations for CAP in Denmark, we have recently conducted and reported a multicentre quality improvement project.4 Based on data from a baseline period (November 2017–February 2018), we designed interventions to improve management of patients hospitalised with CAP at three centres. A fourth hospital served as control centre. The interventions were applied throughout an 8-month intervention period (March–October 2018), and short-term sustainability of the interventions was assessed in a 4-month early follow-up period (November 2018–February 2019). As CAP incidence in Denmark is highest in the cold season, we chose these months for our studies. The outcome measure in the study was adherence to a CAP bundle, consisting of chest X-ray, lower respiratory tract samples, CURB-65 (confusion, urea, respiratory rate, blood pressure, age ≥65) score5 and antibiotics within 8 hours of admission. Adherence to the bundle increased from 11% at baseline to 41% at early follow-up at the intervention centres, with no improvements at the control centre.4 Due to the interdependence of the bundle elements, we considered an adherence of 41% to be a success. However, the main limitation of the previous study was the short follow-up right after … ER -