Selected Podcast
Mortality Committee Update June 2019
In this panel interview, Dr. Zarana Patel and Valerie Leatherman, RN, BSN explain what mortality is, why it's measured and how UM UCH hopes to continue to decrease the expected deaths and improve patient care.
Featuring:
Zarana Patel, MD is the Chair of Mortality Committee, Hospitalist.
Valerie Leatherman RN, BSN | Zarana Patel, MD
Valerie Leatherman, RN is the Manager, Quality Improvement.Zarana Patel, MD is the Chair of Mortality Committee, Hospitalist.
Transcription:
Bill Klaproth (Host): What is mortality and why do we measure it and what does UMUCH hope to accomplish in relation to mortality? Let’s find out with Valerie Leatherman, a registered nurse and manager of quality improvement, and Dr. Zarana Patel, chair of the morality committee and a hospitalist. This is the HERO podcast from UM Upper Chesapeake Health. I’m Bill Klaproth. Dr. Patel let’s start with you, what is the mortality program?
Dr. Zarana Patel (Guest): So at Upper Chesapeake, we started our mortality program in October 2018. It is essentially a program to decrease inpatient hospital deaths. The Google definition of mortality is the number of unexpected deaths within a given area.
Valerie Leatherman (Guest): So basically understanding that hospitals take care of very sick individuals, there is an expected number of deaths that can occur in the hospital setting. These expected deaths are predicted by how sick patients are and then they’re compared to Maryland’s average mortality.
Host: Alright gotcha, so Val let’s stick with you. So why do we measure mortality?
Valerie: So we measure mortality because across the nation, mortality of all hospitals is being monitored right now and used to reward or penalize organizations based on the number of unexpected inpatient hospital deaths.
Dr. Patel: So here at Upper Chesapeake, we realize that there is a direct correlation between quality and safety of care we provide and the unexpected deaths within our facility. It’s important to keep our finger on the pulse so to say to ensure that our patients receive the best care possible.
Host: Alright well that makes sense. So Valerie what does UMUCH hope to accomplish in relation to mortality?
Valerie: I would say the ultimate goal of our mortality program is to decrease the number of unexpected hospital deaths for our patients, and this year to date this program has been able to achieve less hospital deaths than we’ve been projected to have based on how sick our patient population is. Since January Upper Chesapeake Medical Center and Harford Memorial, so both of our facilities, have been leading the University of Maryland’s system in less than expected patient deaths while ultimately improving our patient safety and quality of care.
Host: Well that is really good news. So let me stay with you Val. So how are we accomplishing our mortality goals?
Valerie: So the mortality program, we really attribute the success of the program to multiple patient initiatives that we’ve started within our organization. These initiatives are our guardian nurse programs, the general inpatient hospice programs, provider mortality chart reviews, coding and clinical documentation improvement, and also our rapid responses that we have here in the hospital. So our guardian nurse, just to give you a little bit of an example, is currently an evening shift nurse who’s job it is to monitor all inpatients within our two hospital systems, and with the help of technology and predictive data, this nurse is able to see on a computer screen patients categorized from severely ill to more stable and then with that, the guardian nurse can accurately predict the patients that need immediate medical intervention while generating a proactive response for our patient care and the treatment for our patients.
Dr. Patel: So let me talk about our rapid response team first here. This is the portion where the physicians have been involved the heaviest. Our rapid response committee has been around for quite some time, and the way we run our rapid response committee is we review every rapid response that was called within our hospital system, see if there are any opportunities for improvement, see if there is a moment where we could have recognized the severity of illness earlier rather than later. This helps us prevent further issues down the road with a different patient or even the patient that the rapid response has been called on. It’s more of a preventative measure for the future. For our case reviews, we’ve been doing real time case reviews with attending providers. We take a look at every case that has resulted in unexpected death on our service. The goal is to be more proactive and quickly prevent any adverse patient outcomes in the future. Now at Upper Chesapeake, we recognize that some of our patients are severely ill and that despite our best efforts, we may not be able to resolve all the medical issues and they will eventually succumb to their underlying diseases. The general inpatient hospice program at our facility is a service that we provide in partnership with Med Assist. It is able to provide increased support to the patients that are going through the end of life journey. It’s also able to provide hospice care with patients and families at home, provide support for families an entire year after their loved ones have passed away to help them through the bereavement process.
Valerie: Thanks Dr. Patel, lastly again with accomplishing our mortality goals, we owe a lot of efforts to our coding and clinical documentation improvement team. So all patient care and treatment that a patient receives requires documentation within the patient’s electronic health record. This documentation then is responsible for providing the hospital with a number of expected deaths based on the state calculation that we spoke about earlier. So the coding and clinical documentation improvement teams have worked extremely hard with our hospital providers to ensure that they are accurately documenting, that way it reflects the patient’s conditions and their severity of illnesses.
Host: So then what are the next steps for UMUCH to continue on their journey of preventing outpatient hospital deaths?
Dr. Patel: We’re really excited to announce that our guardian nurse program will be now 24/7 within the next couple of months. This way patients at both facilities will have an extra set of eyes on them 24/7. This program has the potential to expand predictive measures which include patient risks with receiving concurrent opiate and benzodiazepines. With the introduction of Epic, these predictive measures will be displayed on a monitor system that the guardian nurse can view, which can result in early responses, rapid responses being called earlier and early recognition of a patient’s severity of illness.
Host: Well Valerie and Dr. Patel, thank you so much for your time. This is the HERO podcast from UM Upper Chesapeake Health, a podcast for internal communications. Check back soon for our next episode and thanks for listening.
Bill Klaproth (Host): What is mortality and why do we measure it and what does UMUCH hope to accomplish in relation to mortality? Let’s find out with Valerie Leatherman, a registered nurse and manager of quality improvement, and Dr. Zarana Patel, chair of the morality committee and a hospitalist. This is the HERO podcast from UM Upper Chesapeake Health. I’m Bill Klaproth. Dr. Patel let’s start with you, what is the mortality program?
Dr. Zarana Patel (Guest): So at Upper Chesapeake, we started our mortality program in October 2018. It is essentially a program to decrease inpatient hospital deaths. The Google definition of mortality is the number of unexpected deaths within a given area.
Valerie Leatherman (Guest): So basically understanding that hospitals take care of very sick individuals, there is an expected number of deaths that can occur in the hospital setting. These expected deaths are predicted by how sick patients are and then they’re compared to Maryland’s average mortality.
Host: Alright gotcha, so Val let’s stick with you. So why do we measure mortality?
Valerie: So we measure mortality because across the nation, mortality of all hospitals is being monitored right now and used to reward or penalize organizations based on the number of unexpected inpatient hospital deaths.
Dr. Patel: So here at Upper Chesapeake, we realize that there is a direct correlation between quality and safety of care we provide and the unexpected deaths within our facility. It’s important to keep our finger on the pulse so to say to ensure that our patients receive the best care possible.
Host: Alright well that makes sense. So Valerie what does UMUCH hope to accomplish in relation to mortality?
Valerie: I would say the ultimate goal of our mortality program is to decrease the number of unexpected hospital deaths for our patients, and this year to date this program has been able to achieve less hospital deaths than we’ve been projected to have based on how sick our patient population is. Since January Upper Chesapeake Medical Center and Harford Memorial, so both of our facilities, have been leading the University of Maryland’s system in less than expected patient deaths while ultimately improving our patient safety and quality of care.
Host: Well that is really good news. So let me stay with you Val. So how are we accomplishing our mortality goals?
Valerie: So the mortality program, we really attribute the success of the program to multiple patient initiatives that we’ve started within our organization. These initiatives are our guardian nurse programs, the general inpatient hospice programs, provider mortality chart reviews, coding and clinical documentation improvement, and also our rapid responses that we have here in the hospital. So our guardian nurse, just to give you a little bit of an example, is currently an evening shift nurse who’s job it is to monitor all inpatients within our two hospital systems, and with the help of technology and predictive data, this nurse is able to see on a computer screen patients categorized from severely ill to more stable and then with that, the guardian nurse can accurately predict the patients that need immediate medical intervention while generating a proactive response for our patient care and the treatment for our patients.
Dr. Patel: So let me talk about our rapid response team first here. This is the portion where the physicians have been involved the heaviest. Our rapid response committee has been around for quite some time, and the way we run our rapid response committee is we review every rapid response that was called within our hospital system, see if there are any opportunities for improvement, see if there is a moment where we could have recognized the severity of illness earlier rather than later. This helps us prevent further issues down the road with a different patient or even the patient that the rapid response has been called on. It’s more of a preventative measure for the future. For our case reviews, we’ve been doing real time case reviews with attending providers. We take a look at every case that has resulted in unexpected death on our service. The goal is to be more proactive and quickly prevent any adverse patient outcomes in the future. Now at Upper Chesapeake, we recognize that some of our patients are severely ill and that despite our best efforts, we may not be able to resolve all the medical issues and they will eventually succumb to their underlying diseases. The general inpatient hospice program at our facility is a service that we provide in partnership with Med Assist. It is able to provide increased support to the patients that are going through the end of life journey. It’s also able to provide hospice care with patients and families at home, provide support for families an entire year after their loved ones have passed away to help them through the bereavement process.
Valerie: Thanks Dr. Patel, lastly again with accomplishing our mortality goals, we owe a lot of efforts to our coding and clinical documentation improvement team. So all patient care and treatment that a patient receives requires documentation within the patient’s electronic health record. This documentation then is responsible for providing the hospital with a number of expected deaths based on the state calculation that we spoke about earlier. So the coding and clinical documentation improvement teams have worked extremely hard with our hospital providers to ensure that they are accurately documenting, that way it reflects the patient’s conditions and their severity of illnesses.
Host: So then what are the next steps for UMUCH to continue on their journey of preventing outpatient hospital deaths?
Dr. Patel: We’re really excited to announce that our guardian nurse program will be now 24/7 within the next couple of months. This way patients at both facilities will have an extra set of eyes on them 24/7. This program has the potential to expand predictive measures which include patient risks with receiving concurrent opiate and benzodiazepines. With the introduction of Epic, these predictive measures will be displayed on a monitor system that the guardian nurse can view, which can result in early responses, rapid responses being called earlier and early recognition of a patient’s severity of illness.
Host: Well Valerie and Dr. Patel, thank you so much for your time. This is the HERO podcast from UM Upper Chesapeake Health, a podcast for internal communications. Check back soon for our next episode and thanks for listening.