Weiner 2009.

Methods	STUDY DESIGN: ITS Risk of Bias: MEDIUM
Participants	PROVIDERS: all attending emergency physicans, physician assistants, and emergency nurses PARTICIPANTS: all patients with community‐acquired pneumonia CLINICAL PROBLEM: time to first antibiotic dose SETTING: 1 university hospital in the USA
Interventions	FORMAT: Interventions: audit and feedback; reminders (physical, electronic ‐ weekly emails) Intervention Functions: enablement, environmental restructuring, persuasion DELIVERER: departmental nurse administrator COMPARISON: usual care DESIRED CHANGE: increase effective
Outcomes	PRESCRIBING: Choice: mean time to first antibiotic dose (minutes)
Notes	FINANCIAL SUPPORT: Funding: none. Competing Interests: none declared ADDITIONAL DATA: no response from authors to request for additional data
Risk of bias
Bias	Authors' judgement	Support for judgement
Intervention independent (ITS) ?	Low risk
Analysed appropriately (ITS) ?	Low risk	Re‐analysed; our analysis questions the authors' conclusion that the intervention was effective.
Shape of effect pre‐specified (ITS) ?	Low risk	Point of analysis was point of intervention.
Unlikely to affect data collection (ITS) ?	Low risk	TFAD from patient administration system
Knowledge of the allocation adequately prevented(ITS)?	Low risk	TFAD from patient administration system
Incomplete outcome data addressed (ITS) ?	Low risk	TFAD from patient administration system, outcome reported on all included patients.
Free of selected reporting (ITS) ?	Low risk	"Patients were excluded if the time of antibiotic administration was not documented in the electronic medical record, if the patient was documented as having received antibiotics within 48 hours prior to arrival, or if the patient was referred from another facility or clinic with a known diagnosis of pneumonia." Exclusion rate in pre‐intervention period (37/281, 13%) similar to intervention period (40/342, 12%).
Free of other bias (ITS) ?	High risk	Only 11 months' data pre‐ and postintervention