Relationship between preventable hospital deaths and other measures of safety: an exploratory study

Objective. To explore associations between the proportion of hospital deaths that are preventable and other measures of safety. Design. Retrospective case record review to provide estimates of preventable death proportions. Simple monotonie correlations using Spearman's rank correlation coeffic...

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Bibliographic Details
Published in:International journal for quality in health care 2014-06, Vol.26 (3), p.298-307
Main Authors: HOGAN, HELEN, HEALEY, FRANCES, NEALE, GRAHAM, THOMSON, RICHARD, VINCENT, CHARLES, BLACK, NICK
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
England - epidemiology
Epidemiology
Female
General aspects
Health Services Research
Hospital Mortality - trends
Humans
Male
Medical sciences
Patient Safety
Prevention and actions
Public health. Hygiene
Public health. Hygiene-occupational medicine
Quality Indicators, Health Care
Quality insurance (general aspects)
Quality of Health Care
Retrospective Studies
Safety Management - organization & administration
State Medicine
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Summary:Objective. To explore associations between the proportion of hospital deaths that are preventable and other measures of safety. Design. Retrospective case record review to provide estimates of preventable death proportions. Simple monotonie correlations using Spearman's rank correlation coefficient to establish the relationship with eight other measures of patient safety. Setting. Ten English acute hospital trusts. Participants. One thousand patients who died during 2009. Results. The proportion of preventable deaths varied between hospitals (3—8%) but was not statistically significant (P = 0.94). Only one of the eight measures of safety (Methicillin-resistant Staphylococcus aureus bacteraemia rate) was clinically and statistical significantly associated with preventable death proportion (r = 0.73; P < 0.02). There were no significant associations with the other measures including hospital standardized mortality ratios (r = –0.01). There was a suggestion that preventable deaths may be more strongly associated with some other measures of outcome than with process or with structure measures. Conclusions. The exploratory nature of this study inevitably limited its power to provide definitive results. The observed relationships between safety measures suggest that a larger more powerful study is needed to establish the inter-relationship of different measures of safety (structure, process and outcome), in particular the widely used standardized mortality ratios.
ISSN:1353-4505
1464-3677
DOI:10.1093/intqhc/mzu049