So this article (http://www.annemergmed.com/article/S0196-0644(08)01505-9/abstract) notes that there was no increased M&M associated with getting antibiotics out to 8 hours for CAP. But it's not really that straight forward. They noted that they were doing a good job of getting the abx on board early and that the sickest patients, the ones most at risk of significant M&M, were getting them very quickly as expected.

So is this another strike against the hated 4 hour Core Measure? Yes, but it's not strong enough to really strike a death blow.

So this article (http://www.annemergmed.com/article/S0196-0644(08)01505-9/abstract) notes that there was no increased M&M associated with getting antibiotics out to 8 hours for CAP. But it's not really that straight forward. They noted that they were doing a good job of getting the abx on board early and that the sickest patients, the ones most at risk of significant M&M, were getting them very quickly as expected.

So is this another strike against the hated 4 hour Core Measure? Yes, but it's not strong enough to really strike a death blow.

At least the beta-blocker core measure got killed. We stopped worrying about it in April.

The pneumonia one is easy to get around. If they don't get antibiotics in 4 hours, just document that the presentation was unclear and that pneumonia was only diagnosed after extensive testing.