National hospital mortality surveillance system: a descriptive analysis

Cecil, Elizabeth; Wilkinson, Samantha; Bottle, Alex; Esmail, Aneez; Vincent, Charles; Aylin, Paul

doi:10.1136/bmjqs-2018-008364

Cited by 8 publications

(12 citation statements)

References 14 publications

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“…However, some Norwegian hospitals have mortality rates significantly higher than the national average. Although a significant part of the variation observed in hospital mortality can be explained by differences in the case-mix and to random variation, it has been suggested that as much as 30%–60% of this variation can be attributed to differences in the practices and quality of patient care 55. Some hospitals have structures and processes that minimise avoidable patient deaths better than others 56.…”

Section: Discussionmentioning

confidence: 99%

Associations between work satisfaction, engagement and 7-day patient mortality: a cross-sectional survey

Brubakk¹,

Svendsen

Hofoss

et al. 2019

BMJ Open

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ObjectiveThis study examines the association between profession-specific work environments and the 7-day mortality of patients admitted to these units with acute myocardial infarction (AMI), stroke and hip fracture.DesignA cross-sectional study combining patient mortality data extracted from the South-Eastern Norway Health Region, and the work environment scores at the hospital ward levels. A case-mix adjustment model was developed for the comparison between hospital wards.SettingFifty-six patient wards in 20 hospitals administered by the South-Eastern Norway Regional Health Authority.ParticipantsIn total, 46 026 patients admitted to hospitals with AMI, stroke and hip fracture, and supported by 8800 survey responses from physicians, nurses and managers over a 3-year period (2010–2012).Primary and secondary outcome measuresThe primary outcome measures were the associations between the relative mortality rate for patients admitted with AMI, stroke and hip fractures and the profession-specific (ie, nurses, physicians, middle managers) mean scores on the 19 organisational factors in a validated cross sectional, staff survey conducted annually in Norway. The secondary outcome measures were the mean scores with SD on the organisational factors in the staff survey reported by each profession.ResultsThe Nurse workload (beta 0.019 (95% CI0.009–0.028)) and middle manager engagement (beta 0.024 (95% CI0.010–0.037)) levels were associated with a case-mix adjusted 7-day patient mortality rates. There was no significant association between physician work environment scores and patient mortality rates.Conclusion7-day mortality rates in hospital wards were negatively correlated with the nurse workload and manager engagement levels. A deeper understanding of the relationships between patient outcomes, organisational structure and their underlying cultural barriers is needed because they may provide a better understanding of the harm and death risks for patients due to organisational characteristics.

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Section: Discussionmentioning

confidence: 99%

Associations between work satisfaction, engagement and 7-day patient mortality: a cross-sectional survey

Brubakk¹,

Svendsen

Hofoss

et al. 2019

BMJ Open

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“…The utility of incident reporting has been a topic of debate and incident reporting alone is not likely to be sufficient to prevent healthcare associated harm 10. Beyond incident reports, health systems, including the UK National Health Service, have long collected outcome data such as patient mortality and applied these data to detect outlier services with safety concerns 11. A review into state-wide clinical governance in Victoria, triggered by the aforementioned maternity service failure, recommended that multiple and diverse safety performance data, including medicolegal claims, patient complaints and complaints against health practitioners, and outcomes data be shared and analysed jointly to better inform preventative efforts 9.…”

Section: Introductionmentioning

confidence: 99%

Preventing critical failure. Can routinely collected data be repurposed to predict avoidable patient harm? A quantitative descriptive study

Nowotny¹,

Davies‐Tuck²,

Scott³

et al. 2020

BMJ Qual Saf

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ObjectivesTo determine whether sharing of routinely collected health service performance data could have predicted a critical safety failure at an Australian maternity service.DesignObservational quantitative descriptive study.SettingA public hospital maternity service in Victoria, Australia.Data sourcesA public health service; the Victorian state health quality and safety office—Safer Care Victoria; the Health Complaints Commission; Victorian Managed Insurance Authority; Consultative Council on Obstetric and Paediatric Mortality and Morbidity; Paediatric Infant Perinatal Emergency Retrieval; Australian Health Practitioner Regulation Agency.Main outcome measuresNumbers and rates for events (activity, deaths, complaints, litigation, practitioner notifications). Correlation coefficients.ResultsBetween 2000 and 2014 annual birth numbers at the index hospital more than doubled with no change in bed capacity, to be significantly busier than similar services as determined using an independent samples t-test (p<0.001). There were 36 newborn deaths, 11 of which were considered avoidable. Pearson correlations revealed a weak but significant relationship between number of births per birth suite room birth and perinatal mortality (r2=0.18, p=0.003). Independent samples t-tests demonstrated that the rates of emergency neonatal and perinatal transfer were both significantly lower than similar services (both p<0.001). Direct-to-service patient complaints increased ahead of recognised excess perinatal mortality.ConclusionWhile clinical activity data and direct-to-service patient complaints appear to offer promise as potential predictors of health service stress, complaints to regulators and medicolegal activity are less promising as predictors of system failure. Significant changes to how all data are handled would be required to progress such an approach to predicting health service failure.

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“…Therefore, regular evaluation of the information provided by the surveillance system is essential. [678]…”

Section: Introductionmentioning

confidence: 99%

Evaluation of timeliness, simplicity, acceptability, and flexibility in child mortality surveillance system for children aged 1–59 months in Iran

et al. 2019

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Background:Child mortality surveillance system (CMSS) for children aged 1–59 months is a critical issue in the prevention of mortality. This surveillance system like other health programs needs to be evaluated. Therefore, this study aims to evaluate CMSS in Iran.Methods:This evaluation was performed from March 2015 to March 2016 based on selected criteria for assessing the public health surveillance system proposed by the Centers for Disease Control and Prevention. Selected criteria examined in this study included timeliness, simplicity, acceptability, and flexibility. These criteria were evaluated in two ways. First, it included the use of a researcher-made questionnaire. The questionnaires were completed by 100 experts on CMSS. Second, to perform a more exact evaluation of these criteria, 24 of these experts were selected for the focus group.Results:In this study, the response rate was 91% (42% hospital-based and 49% primary care-based). In the timeliness section, 49% of the experts believed that approvals of the child mortality committees have not been sent within the designated time frame; hardware, software, and questionnaires were reported as effective factors in this respect. The structural and administrative problems were effective in simplicity domain and the experts of mortality registration and mood of relatives were effective in acceptability domain. The flexibility of the system was high and appropriate.Conclusions:The findings of the present study reveal that CMSS has some limitations and problems in the timeliness, simplicity, and acceptability criteria, which can be resolved. But this program has an appropriate situation in terms of flexibility.

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National hospital mortality surveillance system: a descriptive analysis

Cited by 8 publications

References 14 publications

Associations between work satisfaction, engagement and 7-day patient mortality: a cross-sectional survey

Associations between work satisfaction, engagement and 7-day patient mortality: a cross-sectional survey

Preventing critical failure. Can routinely collected data be repurposed to predict avoidable patient harm? A quantitative descriptive study

Evaluation of timeliness, simplicity, acceptability, and flexibility in child mortality surveillance system for children aged 1–59 months in Iran

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