Clinicians’ perception of the preventability of inpatient mortality
International Journal of Health Care Quality Assurance
ISSN: 0952-6862
Article publication date: 12 March 2018
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.
Keywords
Acknowledgements
Funding: This audit was undertaken as part of the trust’s ongoing clinical governance and audit program. No additional funding was required.
Competing Interests: The authors have no conflicts of interest to declare.
Citation
Nash, R., Srinivasan, R., Kenway, B. and Quinn, J. (2018), "Clinicians’ perception of the preventability of inpatient mortality", International Journal of Health Care Quality Assurance, Vol. 31 No. 2, pp. 131-139. https://doi.org/10.1108/IJHCQA-06-2016-0083
Publisher
:Emerald Publishing Limited
Copyright © 2018, Emerald Publishing Limited