Nash, R;
Srinivasan, R;
Kenway, B;
Quinn, J;
(2018)
Clinicians' perception of the preventability of inpatient mortality.
International Journal of Health Care Quality Assurance
, 31
(2)
pp. 131-139.
10.1108/IJHCQA-06-2016-0083.
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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.
| Type: | Article |
|---|---|
| Title: | Clinicians' perception of the preventability of inpatient mortality |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1108/IJHCQA-06-2016-0083 |
| Publisher version: | https://doi.org/10.1108/IJHCQA-06-2016-0083 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Clinical audit, Clinical indicators, Health and safety |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10049451 |
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