Artikel
Implementation and evaluation of hospital mortality reviews. A systematic review
Suche in Medline nach
Autoren
-
Moritz Schönfeld
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
-
Hans-Jürgen Bartz
- Department of Quality Management and Clinical Process Management, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
-
Ann Sophie Schröder
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
-
Katrin Kokartis
- Department of Quality Management and Clinical Process Management, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
-
Sandra Eichs
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
-
Martin Härter
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
-
Levente Kriston
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| Veröffentlicht: | 30. September 2022 |
|---|
Gliederung
Text
Background and (inter)national state of research: The number of preventable deaths in hospitals is largely unknown and variance in estimates is high with between <1–85% of all hospital deaths believed to be preventable, depending on methodological aspects such as definitions of preventability and inclusion criteria. In this context, hospitals started the development, implementation, and evaluation of so-called mortality reviews. Mortality reviews aim to identify organizational and individual factors related to preventable deaths and to use this information to improve patient safety and quality of care. Mortality reviews commonly involve a multi-step process including information from clinical staff, clinical experts, and morbidity and mortality conferences. To date, there is no systematic overview of how these reviews are developed, implemented, and evaluated in hospital settings.
Aim and research question: We aim to perform a systematic review of studies describing the characteristics, implementation, and evaluation of hospital mortality reviews.
Methods and hypotheses: The MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, and Web of Science databases were searched in January 2022. Studies describing implementation and/or evaluation of hospital mortality reviews published in English or German will be included. Title/abstract and full text screening is conducted by two independent reviewers. Data extraction and synthesis of included studies will be conducted in May 2022.
Results: We found 883 records in the electronic database search. After title/abstract screening, 15 studies will be included in full text screening. First results suggest that systematic mortality review programs in hospitals are still scarce, but first studies appear to reduce hospital mortality as well as to improve patient safety and quality of care.
Discussion: To our knowledge, this is the first study to systematically search and analyze evidence on mortality reviews in hospital settings. The low number of studies suggest substantial room for research on the development, implementation, and evaluation of mortality reviews.
Practical implications: Hospital mortality is a crucial aspect of clinical care and often used as a quality indicator of care. Still, we know little about organizational and individual factors that are linked to preventable patient deaths. Mortality reviews may be an important tool to assess these factors in order to reduce in-hospital mortality. This systematic review comprises an overview of studies in this area and shows how mortality reviews should be built and implemented in order to adequately review patient deaths in hospitals.
Appeal to practice (science and/or health care) in one sentence: We need to improve and systematize monitoring of in-hospital mortality to help reduce preventable deaths and improve patient care.
Funding: Innovationsfonds/Versorgungsforschung; 01VSF18033
