The Joint Commission Journal on Quality and Patient Safety
The Mortality Review Committee: A Novel and Scalable Approach to Reducing Inpatient Mortality
Section snippets
Setting
The University of Pennsylvania Health System (Philadelphia) is a large (772-bed) urban teaching hospital staffed by more than 1,950 registered nurses and 1,600 physicians and house staff. There are approximately 37,000 admissions annually. Most clinical services sponsor graduate medical education programs. The chief medical officer [P.J.B.], an active infectious disease specialist, reports directly to the chief executive officer and thus has access to hospital resources to support his efforts.
Targeting Reduction in the Mortality Index
Mortality Index and Observed Mortality Rate
In 2009 the Center for Evidence-based Practice at Penn Medicine was asked to examine the impact of the Mortality Review Committee on the mortality index. Given that the committee was established in 2006, the center examined the time period from 2006 to 2009. During this period, numerous quality interventions occurred simultaneously (Table 1; and Table 2, right). Thus, it was not possible to identify direct causal relationships between any one intervention and improvements in mortality; however,
Discussion
We have described the use of a multidisciplinary mortality review committee to address inpatient mortality at a large, urban academic hospital. The diversity of the committee membership encouraged a multipronged approach to QI initiatives. Highlighting two initiatives developed and implemented by the committee to address sepsis and delirium, we demonstrate the enormous success that can be achieved through a systematic approach to mortality reduction. With 37,000 admissions annually, the
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