FIGURE 4-6 ORYX results for pneumonia patients at the Lovell Federal Health Care Center, 2008–2011 (percentage of patients).
NOTE: Results for 2009 are not included because composite measures were used that year rather than individual measures. PN-1 = pneumonia patient oxygenation assessed; PN-2 = pneumonia patients assessed and given pneumococcal vaccination; PN-3a = blood cultures were performed within 24 hours prior to or 24 hours after hospital arrival for patients who were transferred or admitted to the intensive care unit (ICU); PN-3b = initial emergency room blood culture was performed prior to the administration of the first hospital dose of antibiotics; PN-4 = smoking cessation advice/counseling given; PN-5c = initial antibiotic received within 6 hours of hospital arrival; PN-6a = initial antibiotic selection for community-acquired pneumonia (CAP) in immunocompetent ICU patient; PN-6b = initial antibiotic selection for CAP immunocompetent non-ICU patient; PN-7 = pneumonia patients assessed and given influenza vaccination.

Cost Effectiveness

No evidence was found regarding cost effectiveness, but some was found with regard to cost savings. The notable savings were in avoidance of construction costs and the reduction of Navy inpatient full-time equivalent (FTE) positions because the VA took over staffing of the nursing wards. There are also some operating efficiencies. However, there was no quantification of extra cost of duplicate administrative services to meet different standards and reporting requirements for similar functions.

Staff at the Lovell FHCC prepared a cost-benefit analysis of the Lovell FHCC merger in February 2009. The analysis reported that the annual savings from the Phase I move of inpatient mental health services from the

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