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A national hospital mortality surveillance system: a descriptive analysis

Cecil, Ev ; Wilkinson, S ; Bottle, R ; Esmail, A ; Vincent, C ; Aylin, P; National Institute for Health Research ; National Institute for Health Research ; National Institute for Health Research ; Dr Foster Intelligence

BMJ Quality and Safety, 01 December 2018 [Tạp chí có phản biện]

ISSN: 2044-5415 ; ISBN: 10 DOI: 10.1136/bmjqs-2018-008364

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  • Nhan đề:
    A national hospital mortality surveillance system: a descriptive analysis
  • Tác giả: Cecil, Ev ; Wilkinson, S ; Bottle, R ; Esmail, A ; Vincent, C ; Aylin, P
  • National Institute for Health Research ; National Institute for Health Research ; National Institute for Health Research ; Dr Foster Intelligence
  • Chủ đề: Science & Technology ; Life Sciences & Biomedicine ; Health Care Sciences & Services ; Health Policy & Services ; Hospital Mortality ; Quality of Care ; Deaths ; Hospital Mortality ; Quality of Care
  • Là 1 phần của: BMJ Quality and Safety, 01 December 2018
  • Mô tả: Objective To provide a description of the Imperial College Mortality Surveillance System and subsequent investigations by the Care Quality Commission (CQC) in National Health Service (NHS) hospitals receiving mortality alerts. Background The mortality surveillance system has generated monthly mortality alerts since 2007, on 122 individual diagnosis and surgical procedure groups, using routinely collected hospital administrative data for all English acute NHS hospital trusts. The CQC, the English national regulator, is notified of each alert. This study describes the findings of CQC investigations of alerting trusts. Methods We carried out (1) a descriptive analysis of alerts (2007–2016) and (2) an audit of CQC investigations in a subset of alerts (2011–2013). Results Between April 2007 and October 2016, 860 alerts were generated and 76% (654 alerts) were sent to trusts. Alert volumes varied over time (range: 40–101). Septicaemia (except in labour) was the most commonly alerting group (11.5% alerts sent). We reviewed CQC communications in a subset of 204 alerts from 96 trusts. The CQC investigated 75% (154/204) of alerts. In 90% of these pursued alerts, trusts returned evidence of local case note reviews (140/154). These reviews found areas of care that could be improved in 69% (106/154) of alerts. In 25% (38/154) trusts considered that identified failings in care could have impacted on patient outcomes. The CQC investigations resulted in full trust action plans in 77% (118/154) of all pursued alerts. Conclusion The mortality surveillance system has generated a large number of alerts since 2007. Quality of care problems were found in 69% of alerts with CQC investigations, and one in four trusts reported that failings in care may have an impact on patient outcomes. Identifying whether mortality alerts are the most efficient means to highlight areas of substandard care will require further investigation.
  • Nơi xuất bản: BMJ Publishing Group
  • Số nhận dạng: ISSN: 2044-5415 ; ISBN: 10 DOI: 10.1136/bmjqs-2018-008364

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