Understanding and improving inpatient mortality in academic medical centers

Academic Medicine : Journal of the Association of American Medical Colleges
Raj Behal, Jeannine Finn

Abstract

The purpose of this article is to describe factors contributing to potentially preventable mortality in academic medical centers and the organizational characteristics associated with success in reducing mortality. Sixteen U.S. academic medical centers that wished to improve risk-adjusted inpatient mortality rates requested a consultation that included interviews with physicians, nurses, and hospital leaders; review of medical records; and evaluation of systems and processes of care. The assessments took place on-site; they identified key factors contributing to preventable mortality, and each hospital received specific recommendations. Changes in observed mortality and in the ratio of observed to expected mortality were measured from 2002 to final follow-up in 2007. Evaluations determined each hospital's success factors and key barriers to improvement. The key factors contributing to preventable mortality were delays in responding to deteriorating patients, suboptimal critical care, hospital-acquired infections, postoperative complications, medical errors, and community issues such as the availability of hospice care. Of the 16 hospitals, 12 were able to reduce their mortality index. The five hospitals that had the greatest im...Continue Reading

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Citations

Mar 1, 2012·Academic Medicine : Journal of the Association of American Medical Colleges·Daniel M BlumenthalRichard Bohmer
Sep 4, 2012·Journal of Graduate Medical Education·Eileen T McMylerMonica L Lypson
Jun 12, 2013·The Journal of Surgical Research·Joshua J ShawShimul A Shah
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Jun 18, 2011·Annals of Neurology·Robert G Holloway, Steven P Ringel
Mar 7, 2014·Critical Care Nursing Quarterly·Elizabeth H LazzaraEduardo Salas

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