Clinicians' perception of the preventability of inpatient mortality. Issue 2 (12th March 2018)

• Record Type: Journal Article
• Authors: Nash, Robert; Srinivasan, Ramya; Kenway, Bruno; Quinn, James
• Is Part Of: International journal of health care quality assurance. Volume 31:Issue 2(2018)
• Page Start: 131
• Page End: 139
• Publication Date: 2018-03-12
• Subjects: Clinical audit -- Clinical indicators -- Health and safety; Medical care -- Quality control -- Periodicals; 362.1068
• DOI: 10.1108/IJHCQA-06-2016-0083
• Languages: English
• ISSNs: 0952-6862

Abstract

Abstract : Purpose: The purpose of this paper is to assess whether clinicians have an accurate perception of the preventability of their patients' mortality. Case note review estimates that approximately 5 percent of inpatient deaths are preventable. Design/methodology/approach: The design involved in the study is a prospective audit of inpatient mortality in a single NHS hospital trust. The case study includes 979 inpatient mortalities. A number of outcome measures were recorded, including a Likert scale of the preventability of death- and NCEPOD-based grading of care quality. Findings: Clinicians assessed only 1.4 percent of deaths as likely to be preventable. This is significantly lower than previously published values ( p <0.0001). Clinicians were also more likely to rate the quality of care as "good, " and less likely to identify areas of substandard clinical or organizational management. Research limitations/implications: The implications of objective assessment of the preventability of mortality are essential to drive quality improvement in this area. Practical implications: There is a wide disparity between independent case note review and clinicians assessing the care of their own patients. This may be due to a "knowledge gap" between reviewers and treating clinicians, or an "objectivity gap" meaning clinicians may not recognize preventability of death of patients under their care. Social implications: This study gives some insight into deficiencies in clinical governance processes. Originality/value: No similar study has been performed. This has significant implications for the idea of the preventability of mortality.