PT - JOURNAL ARTICLE AU - Divya Tiwari AU - Alyson O'Donnell AU - Richard Renaut AU - Tristan Richardson AU - Stephen Allen TI - Reducing hospital mortality: Incremental change informed by structured mortality review is effective AID - 10.7861/fhj.2019-0022 DP - 2020 Jun 01 TA - Future Healthcare Journal PG - 143--148 VI - 7 IP - 2 4099 - http://www.rcpjournals.org/content/7/2/143.short 4100 - http://www.rcpjournals.org/content/7/2/143.full SO - Future Healthc J2020 Jun 01; 7 AB - Hospital mortality rates have frequently been improved by identifying diagnostic groups with high mortality and targeting interventions to those specific groups. We found that high residual inpatient mortality persisted after targeted measures had achieved an initial reduction, and that the causes were spread across a wide range of diagnostic groups. Further interventions were put in place consisting of a structured electronic mortality form and systematised mortality scrutiny and reporting (primary intervention) accompanied by a number of quality improvement interventions arising from the mortality analysis (secondary interventions). We found that those interventions were associated with progressive improvements in mortality rates and average lengths of inpatient stay over the 5-year study period. Winter quarter mortality improvements reached a high level of statistical significance but could not be attributed to changes in any particular diagnostic groups. We conclude that progress with mortality improvements is probably best achieved by applying both code-targeted and general interventions simultaneously.