How an understanding of mortality data can drive cultural change and unlock sustainable improvement

For healthcare organisations, tracking and interpreting a wide range of mortality metrics is a complex and time-consuming task. It is, however, crucial to the delivery of high-quality patient care, as mortality data offers a comprehensive view of services that can be used to drive effective improvement whilst at the same time improving patient safety.

That’s why making mortality metrics more accessible to clinicians is key to creating sustainable change. When data is transformed into meaningful insights that clinicians understand in the context of their practice, they are more invested in the role they play in producing it.

This was undoubtedly the case for United Lincolnshire Hospitals. The trust was seeing a consistently high hospital standardised mortality ratio (HSMR) for a number of years, which led to its inclusion in the 2013 Keogh Review. With support from Dr Foster, the trust began a long-term campaign of improvement to tackle the issue.

We undertook detailed analyses of mortality across specialties and diagnosis groups in order to pinpoint where improvement was most urgently needed and where it would have the biggest impact. The trust was able to further identify areas of variation by benchmarking against peers. As a result, the trust was able to home in on and target specific areas of care. Drilling down in this way also compelled departments to take greater ownership over their data.

Dr Foster’s review of specialties revealed large disparities in coding quality across departments. To educate staff around correct coding and the impact it has on mortality ratios, income, and contracting, United Lincolnshire Hospitals launched regular clinical coding masterclasses, which are still ongoing. The quality of information being recorded is now much higher and more consistent because clinicians are more aware of its importance. This work, alongside several other initiatives, has resulted in a successful reduction in mortality, leading to the lowest HSMR the trust has ever seen.  

To help other trusts gain a clearer understanding of their mortality metrics and foster sustainable improvements, Dr Foster has developed a mortality consultancy service. The bespoke service delivers data monitoring tools and regular reports across multiple models, and the expertise to identify and interpret key metrics, providing trusts with a consistent and holistic view of mortality.

As well as saving valuable time and resources, the service aims to enable trusts to make mortality a trust-wide concern and drive evidence-based changes that improve patient care.

You can read more about the United Lincolnshire Hospitals improvement journey here. For more information about the Dr Foster mortality consultancy service, get in touch here.

You can find out more about Matthew Parry here, who is a senior consultant at Dr Foster.