Preventable hospital deaths and other measures of safety

Readers of this blog may well know the views of the CLAHRC WM Director on using hospital mortality to compare hospital safety.[1] [2] Following the recommendations in the Keogh review, published in 2013, there was greater interest in looking at preventable hospital deaths in order to improve the NHS.

Helen Hogan and colleagues have recently published findings of a retrospective case record review that looked for relationships between preventable hospital deaths and eight other measures of safety in ten English acute hospital trusts.[3] Of the eight measures of safety they looked at, only MRSA bacteraemia rate had a significant association with proportion of preventable deaths (P<0.02). Hospital Standardised Mortality Ratios (HSMRs), widely used in the UK to measure safety, was not significantly associated (P=0.97). Additionally, the difference in the proportion of preventable deaths between hospitals was not statistically significant (P=0.94), varying from 3–8%. The authors are planning a larger study in order to establish these findings, with 24 additional UK hospitals.

— Richard Lilford, Director CLAHRC WM

References:

  1. Girling AJ, Hofer TP, Wu J, Chilton PJ, Nicholl JP, Mohammed MA, Lilford RJ. Case-mix adjusted hospital mortality is a poor proxy for preventable mortality: a modelling study. BMJ Qual Saf. 2012; 21(12): 1052-6.
  2. Lilford RJ, Pronovost P. Using hospital mortality rates to judge hospital performance: a bad idea that just won’t go away. BMJ. 2010; 340: c2016.
  3. Hogan H, Healey F, Neale G, Thomson R, Vincent C, Black N. Relationship between preventable hospital deaths and other measures of safety: an exploratory study. Int J Qual Health Care. 2014; 26(3): 298-307.
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