The number of deaths in Lincolnshire’s hospitals are at an all-time low thanks to new and improved initiatives to increase the quality of care for patients.
The mortality rate for United Lincolnshire Hospitals NHS Trust has fallen to the lowest rate ever as staff continue to implement across-the-board improvements in patient care, leading to 208 less deaths than expected between April 2018 and March 2019.
Data on mortality rates, known as Hospital Standardised Mortality Ratio (HSMR), shows that the current score for the Trust is now at an average of 89.43 for the last year, performing within the best 22% of Trusts nationally.
HSMR is designed to assess whether the number of hospital deaths is higher or lower than expected, depending on the case mix of patients involved. It is calculated by healthcare analysis organisation Dr Foster and the national average is given a score of 100.
The Trust was placed in quality special measures after its higher-than-expected mortality rates for 2012/13 prompted a review by Sir Bruce Keogh, Medical Director for England. The current HSMR is the lowest recorded since then.
For the Summary Hospital-level Mortality Indicator (SHMI), the current performance for ULHT is also within expected limits at 109.92 .This measure looks at all in-hospital deaths as well as those deaths where the patient died 30 days after discharge from hospital.
Key areas where improvements have been made are:
- Improved cleanliness and infection rates.
- Introduction of medical examiner roles to review every death.
- In-depth reviews into issues with certain health conditions.
- Workshops with clinicians around accurate documentation.
- Improved use of care bundles
- Investment in the clinical coding department to ensure engagement with clinical staff and accurate recording of patient’s conditions and reflection of the care received.
- System-wide working across Lincolnshire to improve care and identify shared learning.
Dr Neill Hepburn, Medical Director at ULHT, said: “This is a fantastic achievement and is due to the hard work of all our staff. We can’t underestimate the massive progress we have made as a Trust over the past few years.
“There’s no single factor that led to the reduction, it is due to widespread improvements to quality of patient care and fostering a safety culture at our hospitals.
“To have achieved a reduction from 113 to 89.42 is a real testament to everyone’s hard work and commitment to improve patient care. Every member of staff has contributed to this improvement journey.
“We won’t sit on our laurels. There is still more work to be done and we are working hard to get out of special measures and continue to make long-term changes to the quality of our services.”
- In 2013, our higher than expected mortality rates prompted a review by Sir Bruce Keogh, Medical Director for England. Following the review, we were placed in special measures.
- The Hospital Standardised Mortality Ratio (HSMR) is one measure of mortality rates in a hospital. It is administered by independent Dr Foster. A mortality rate is designed to assess whether the number of deaths in a hospital is higher or lower than expected, depending on the case mix of patients involved. It is a comparative measure, which shows the position of each trust in relation to other hospitals. The national average is set at a score of 100; more than 100 means that a trust’s mortality rates are higher than the average, or expected, less than 100 means they are lower than the average.
- SHMI is an indicator which reports mortality across the NHS in England using a standard and transparent methodology. SHMI includes all in-hospital deaths and those deaths where the patient died 30 days after discharge from hospital.
- Each year the rates are re-assessed, so trusts are then given different rates depending on how they are doing in comparison with each other. There will always be a certain number above and below the expected ranges.
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