Safety checklists cut patient deaths

19 April 2010

PATIENT deaths at three trouble-hit hospitals have been cut by 15 per cent thanks to a new system of treatment checklists.

The North West London Hospitals NHS Trust came under fire between 2005 and 2006 over the death rates at three of its hospitals. The trust, which serves a population of 500,000 people, was criticised over standards at Northwick Park, Central Middlesex and St Mark’s hospitals.

A group of senior clinicians, led by Professor Sir Brian Jarman from Imperial College London, set out to cut mortality rates and boost public confidence in the trust. They developed eight care bundles for 13 diagnostic areas with the highest number of deaths at the trust in 2006 and 2007. These included treatments for stroke, heart failure and chronic obstructive pulmonary disease (COPD).

Care bundles are a collection of treatment checklists based on clinical guidelines that, when combined, improve the effectiveness and safety of patient care.

Following the implementation of the system, analysis of the hospital’s mortality rate showed it had fallen to the point where it became the lowest among acute trusts in England.

In 2007-2008, 174 fewer deaths occurred in the trust in the targeted diagnoses and 255 fewer deaths occurred in the hospital standardised mortality ratio (HSMR) diagnoses compared to 2006-2007. The HSMR measures a hospital’s overall mortality and focuses on a group of diagnoses that account for 80 per cent of all hospital deaths nationally.

The study shows that care bundles can be targeted across a range of diagnoses in a busy acute hospital trust which can subsequently reduce mortality in those areas.