Ventilator-associated pneumonia--the wrong quality measure for benchmarking

Ann Intern Med. 2007 Dec 4;147(11):803-5. doi: 10.7326/0003-4819-147-11-200712040-00013.


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.

MeSH terms

  • Benchmarking*
  • Diagnostic Errors
  • Hospitals / standards*
  • Humans
  • Pneumonia, Ventilator-Associated / diagnosis*
  • United States