Surgeon-Led Review Improves Mortality Ratios

A surgeon-led systematic review of mortality may help improve observed to expected mortality ratios and postsurgical mortality rankings, according to a study published in the Journal of the American College of Surgeons.

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Researchers implemented a monthly surgeon-led review on 12 surgical services. The surgeons reported on preventability and accuracy of all mortalities, patient safety indicators and healthcare-associated infections.

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The study found the observed to expected mortality ratio decreased from 1.14 in the fourth quarter of 2012 to 0.75 in the third quarter of 2013, a 34 percent decrease. A ratio of less than one indicates fewer observed deaths than expected deaths.

Additionally, their IQI 90 mortality ranking increased from 109/118 in the third quarter of 2012 to 47/119 in the third quarter of 2013. IQI 90 is an inpatient quality indicator developed by the Agency of Healthcare Research and Quality that looks at the reliability-adjusted mortality indicators.

Researchers suggest surgeon engagement and ownership is imperative to clinical improvements.

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