Cut in death rate boost for hospital

Dr Mark Juniper, a  consultant at GWH

Dr Mark Juniper, a consultant at GWH

First published in News by

MORTALITY rates at the Great Western Hospital are at their lowest since 2012 with 1,696 deaths reported in the last year.

This is two per cent, or approximately 35 deaths, lower than initially expected under the Summary Hospital-level Mortality Indicator or SHMI, which monitors deaths that occur in hospital and in patients’ homes within 30 days of discharge.

Each year, every hospital in the country attempts to achieve mortality rates of one or under. Above one is considered unacceptably high.

Between January 2013 and December 2013, GWH achieved a value 0.98.

This represented a major improvement from the 1.04 recorded between April 11 and March 2012.

The significant drop resulted from a series of drives to tackle the main infections responsible for hospital deaths as well as campaigns to improve patient care and monitoring to ensure better survival rates.

Mark Juniper, consultant in respiratory and intensive care medicine, said: “Our SHMI was not so good in April 2011-March 2012, but we started monitoring mortality rates every month. We have reduced the number of hospital-acquired infections and we have improved the rate of clostridium difficile, which is a case of antibiotic-associated colitis (diarrhoea), which has a 25 per cent mortality rate.

“We have introduced pre-operative screening to identify high-risk patients and mortality and morbidity meetings across different services to ensure people learn lessons to help reduce the number of patients who die.

“But part of this has also been about learning from other organisations and about sharing information. We try to replicate good results in other trusts and put them in place here. We have also been looking at what other countries like the US have done to lower mortality rates.”

The recent introduction of the Sepsis Six, a set of simple interventions, including prescribing antibiotics, giving patients oxygen and intravenous fluids, within the first hour of diagnosis, has also made a tremendous difference and increased survival by up to 30 per cent.

Since February alone, death rates have dropped from 63 per cent to 25 per cent.

On the back of the Sepsis Six, the hospital will soon roll out a similar set of checks to identify patients at risk of acute kidney injury, or renal failure.

“Over the years we have not targeted particular patient groups,” he added. “What we did was try to learn about the things we had been doing and improving them. But what we did recently, and sepsis is part of this, is targeting conditions that kill people relatively commonly and see what we could do to improve the care of patients with these conditions. Moving forward we want to introduce additional measures to improve mortality rates. For example, acute kidney injury, which increases the risk of death substantially.

“The bar is raised nationally at the end of every year and the statistics go up to make sure we constantly improve. It’s a way to make sure we are not complacent.

“The challenge now is to work out the next big steps to take that further improve the care of patients.”

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