Establishing a Mortality Review Process

Rachel, Marcia; Stewart, Mary W.

doi:10.1097/ncq.0b013e31819b8e45

Cited by 3 publications

(2 citation statements)

References 13 publications

(4 reference statements)

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“…It is also clear that it is incorrect to make direct comparisons of mortality between hospitals without adjusting for differences in case mix. Understanding mortality within hospitals nevertheless remains important particularly for understanding and improving the quality of care in addition to tracking change over time 42, 43 .…”

Section: Discussionmentioning

confidence: 99%

Competing risk survival analysis of time to in-hospital death or discharge in a large urban neonatal unit in Kenya

et al. 2019

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Background: Clinical outcomes data are a crucial component of efforts to improve health systems globally. Strengthening of these health systems is essential if the Sustainable Development Goals (SDG) are to be achieved. Target 3.2 of SDG Goal 3 is to end preventable deaths and reduce neonatal mortality to 12 per 1,000 or lower by 2030. There is a paucity of data on neonatal in-hospital mortality in Kenya that is poorly captured in the existing health information system. Better measurement of neonatal mortality in facilities may help promote improvements in the quality of health care that will be important to achieving SDG 3 in countries such as Kenya. Methods: This was a cohort study using routinely collected data from a large urban neonatal unit in Nairobi, Kenya. All the patients admitted to the unit between April 2014 to December 2015 were included. Clinical characteristics are summarised descriptively, while the competing risk method was used to estimate the probability of in-hospital mortality considering discharge alive as the competing risk. Results: A total of 9,115 patients were included. Most were males (966/9115, 55%) and the majority (6287/9115, 69%) had normal birthweight (2.5 to 4 kg). Median length of stay was 2 days (range, 0 to 98 days) while crude mortality was 9.2% (839/9115). The probability of in-hospital death was higher than discharge alive for birthweight less than 1.5 kg with the transition to higher probability of discharge alive observed after the first week in birthweight 1.5 to <2 kg. Conclusions: These prognostic data may inform decision making, e.g. in the organisation of neonatal in-patient service delivery to improve the quality of care. More of such data are therefore required from neonatal units in Kenya and other low resources settings especially as more advanced neonatal care is scaled up.

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Section: Discussionmentioning

confidence: 99%

Competing risk survival analysis of time to in-hospital death or discharge in a large urban neonatal unit in Kenya

et al. 2019

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“…1 To improve patient care, many healthcare organizations review sentinel events, 2 study patient mortality data, 3 and convene morbidity and mortality conferences. 4 The goal of these endeavors is to prevent adverse events by identifying root causes and solutions.…”

Section: Introductionmentioning

confidence: 99%

Measuring Faculty Reflection on Adverse Patient Events: Development and Initial Validation of a Case-Based Learning System

et al. 2010

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Improve Healthcare Quality Through Mortality Committee: Retrospective Analysis of Bambino Gesù Children Hospital’s Ten Years’ Experience 2008-2017

Offidani

Lodise

Gatto

et al. 2019

CPB

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Background: Healthcare quality improvements are one of the most important goals to reach a better and safer healthcare system. Reviewing in-hospital mortality data is useful to identify areas for improvement, and to monitor the impact of actions taken to avoid preventable cases, such as those related to healthcare associated infections (HAI). Methods: In this paper, we present the experience of the Mortality Committee of Bambino Gesù Children Hospital (OPBG). OPBG has instituted a process of systematic revision of all in-hospital deaths conducted by a multidisciplinary team. The goal is to identify system-wide issues that could be improved to reduce in-hospital preventable deaths. In this way, the mortality review goes alongside all the other risk management activities for the continuous quality improvement and patient safety. Results: In years 2008-2017, we performed a systematic analysis of 1148 inpatient deaths. In this time period, the overall mortality rate was 0.4%. Forty-seven deaths were caused due to infections, 10 of which involved patients with HAI transferred to OPBG from other facilities or patients with community- acquired infections. Six deaths related to HAI were followed by claims compensations. All these cases were not followed by compensation because the onset of HAI was considered an inevitable consequence of the underlying disease. Conclusion: Introduction of the mortality review committee has proved to be a valid instrument to improve the quality of the care provided in a hospital, allowing early identification of care gaps that could lead to an increase in mortality rates. Article Highlights Box: Reduction of preventable deaths is one of the most important goals to be achieved for any health-care system and to improve the quality of care. • Several studies have shown that analysis of morbidity and mortality rate helps to detect any factors that can lead to an increase in in-hospital mortality rates. • The review of in-hospital deaths allows to learn how to improve the quality and safety of care through identification of critical issues that lead to an increase in mortality ratio. • In some medical areas, such as intensive care units or surgery, the implementation of the conference on mortality and morbidity is more useful for assessing procedures at high risk of errors. • The implementation of existing databases with data deriving from the systematic review of medical records and in-hospital deaths appears to be desirable. • Mortality Review Committees can represent a very useful tool for all the health facilities for the reduction of preventable deaths, such as those related to HAI.

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Establishing a Mortality Review Process

Cited by 3 publications

References 13 publications

Competing risk survival analysis of time to in-hospital death or discharge in a large urban neonatal unit in Kenya

Competing risk survival analysis of time to in-hospital death or discharge in a large urban neonatal unit in Kenya

Measuring Faculty Reflection on Adverse Patient Events: Development and Initial Validation of a Case-Based Learning System

Improve Healthcare Quality Through Mortality Committee: Retrospective Analysis of Bambino Gesù Children Hospital’s Ten Years’ Experience 2008-2017

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