RT Journal Article
SR Electronic
T1 Reducing hospital mortality: Incremental change informed by structured mortality review is effective
JF Future Healthcare Journal
JO Future Healthc J
FD Royal College of Physicians
SP 143
OP 148
DO 10.7861/fhj.2019-0022
VO 7
IS 2
A1 Divya Tiwari
A1 Alyson O'Donnell
A1 Richard Renaut
A1 Tristan Richardson
A1 Stephen Allen
YR 2020
UL http://www.rcpjournals.org/content/7/2/143.abstract
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.