Mortality rates in US hospitals vary widely when calculated in a standardized way. Systematic analysis of hospital deaths can reveal some of the reasons for this variation. When hospital deaths are categorized according to the level and type of care, patterns emerge that can highlight system defects.
As part of its effort to foster improvement in health care systems, IHI developed an analytical tool for understanding hospital mortality rates, described in detail in an IHI Innovation Series white paper entitled Move Your Dot: Measuring, Evaluating, and Reducing Hospital Mortality Rates.
In 2002, a pilot group of eight hospitals — six from the US and two from the UK — began working with the Institute for Healthcare Improvement to analyze inpatient mortality, and to test IHI’s hypothesis that a combination of evidence-based interventions can reduce mortality rates.
Each hospital implemented strategies proven to reduce mortality, including, but not limited to, Multidisciplinary Rounds, Rapid Response Teams, and the Ventilator Bundle (a group of interventions designed to improve care of patients on ventilators). Use of these strategies reduces the number of “code calls” — that is, “code blue,” “crash call” (UK), cardiopulmonary arrest — per thousand discharges and the incidence of ventilator-associated pneumonia.
IHI believes that mortality can be consistently reduced through the use of a combination of evidence-based interventions. A number of hospitals working with IHI have been testing this theory, and the preliminary results generally are encouraging.
