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Impact of postgraduate education on physician practice for community-acquired pneumonia.
J Eval Clin Pract. 2012 Apr; 18(2):389-95.JE

Abstract

BACKGROUND

Clinical practice guidelines on community-acquired pneumonia (CAP) are widely recognized by hospitals in Japan; however, little is known about the effect of postgraduate education on physicians' adherence to the guidelines or on patient outcomes.

METHOD

We conducted a chart review of inpatient CAP cases at a single teaching hospital in Japan from 2003 to 2005, during which the educational programme for residents was gradually reinforced by the introduction of multifaceted education and training in the management of infectious diseases. To assess the effects of this educational programme, we measured process indicators such as usage of diagnostic tests, choice of antibiotics, and clinical outcomes, including length of antibiotic treatment, length of stay, and mortality.

RESULTS

Several improvements were observed after educational intervention: (1) more frequent blood, sputum cultures, and Gram stain tests; (2) less frequent use of broad-spectrum antibiotics as the initial empiric therapy (from 50% to 12%) and on hospital day 5 (from 66.7% to 10%); and (3) median length of stay was shorter after intervention (16.5 days to 13 days).

CONCLUSIONS

Our findings suggest that multifaceted educational intervention for residents focused on diagnostic efforts, including Gram stain and cultures, choice of antibiotics with the appropriate spectrum, and de-escalation of antibiotics, can increase adherence to CAP guidelines as well as improve clinical outcomes.

Authors+Show Affiliations

Department of Primary Care and Emergency Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan. hikai-kyt@umin.netNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21208347

Citation

Ikai, Hiroshi, et al. "Impact of Postgraduate Education On Physician Practice for Community-acquired Pneumonia." Journal of Evaluation in Clinical Practice, vol. 18, no. 2, 2012, pp. 389-95.
Ikai H, Morimoto T, Shimbo T, et al. Impact of postgraduate education on physician practice for community-acquired pneumonia. J Eval Clin Pract. 2012;18(2):389-95.
Ikai, H., Morimoto, T., Shimbo, T., Imanaka, Y., & Koike, K. (2012). Impact of postgraduate education on physician practice for community-acquired pneumonia. Journal of Evaluation in Clinical Practice, 18(2), 389-95. https://doi.org/10.1111/j.1365-2753.2010.01594.x
Ikai H, et al. Impact of Postgraduate Education On Physician Practice for Community-acquired Pneumonia. J Eval Clin Pract. 2012;18(2):389-95. PubMed PMID: 21208347.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of postgraduate education on physician practice for community-acquired pneumonia. AU - Ikai,Hiroshi, AU - Morimoto,Takeshi, AU - Shimbo,Takuro, AU - Imanaka,Yuichi, AU - Koike,Kaoru, Y1 - 2011/01/05/ PY - 2011/1/7/entrez PY - 2011/1/7/pubmed PY - 2012/7/20/medline SP - 389 EP - 95 JF - Journal of evaluation in clinical practice JO - J Eval Clin Pract VL - 18 IS - 2 N2 - BACKGROUND: Clinical practice guidelines on community-acquired pneumonia (CAP) are widely recognized by hospitals in Japan; however, little is known about the effect of postgraduate education on physicians' adherence to the guidelines or on patient outcomes. METHOD: We conducted a chart review of inpatient CAP cases at a single teaching hospital in Japan from 2003 to 2005, during which the educational programme for residents was gradually reinforced by the introduction of multifaceted education and training in the management of infectious diseases. To assess the effects of this educational programme, we measured process indicators such as usage of diagnostic tests, choice of antibiotics, and clinical outcomes, including length of antibiotic treatment, length of stay, and mortality. RESULTS: Several improvements were observed after educational intervention: (1) more frequent blood, sputum cultures, and Gram stain tests; (2) less frequent use of broad-spectrum antibiotics as the initial empiric therapy (from 50% to 12%) and on hospital day 5 (from 66.7% to 10%); and (3) median length of stay was shorter after intervention (16.5 days to 13 days). CONCLUSIONS: Our findings suggest that multifaceted educational intervention for residents focused on diagnostic efforts, including Gram stain and cultures, choice of antibiotics with the appropriate spectrum, and de-escalation of antibiotics, can increase adherence to CAP guidelines as well as improve clinical outcomes. SN - 1365-2753 UR - https://www.unboundmedicine.com/medline/citation/21208347/Impact_of_postgraduate_education_on_physician_practice_for_community_acquired_pneumonia_ L2 - https://doi.org/10.1111/j.1365-2753.2010.01594.x DB - PRIME DP - Unbound Medicine ER -