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Mortality rates heading in the right direction

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George Eliot Hospital’s Chief Executive says that the Trust’s ‘journey’ to transform health care for local people is heading in the right direction. The announcement comes as data released by the Department of Health shows improvements to its mortality rates.

Despite reporting rates still being below the standards patients would expect, the Trust has made improvements to its Standardised Hospital Mortality Indicator (SHMI), reducing from 1.21 reported in October 2011 to 1.16 reported in October 2012; this against a national baseline figure of 1.00.*

Following the release of mortality data last year, which highlighted the George Eliot as having the highest mortality rate in England, the Trust commissioned an external review to establish why the rate was so high and what could be done to improve it. This review identified four key areas for improvement** and led to the introduction of a range of actions to improve the Trust’s historically high mortality rates.

Since then, significant improvements have been made to quality of care including:

  • Big reductions in pressure sores – success recognised with the Trust being shortlisted in the ‘Care of the Elderly’ category of the Nursing Times Awards 2012***.

  • Improved seven-day service for key services such as pathology, pharmacy and radiography.

  • Continuity of care – An analysis of ‘patient flows’ has resulted in the number of times a patient is moved per hospital stay dropping from 3.6 to 2.2. A special focus has been placed on vulnerable and confused patients.

  • Improvements in ‘cleanliness’, ‘nutrition’ and ‘privacy and dignity’ recognised with a verdict of ‘excellent’ in all three areas in a recent inspection**** .

  • Maintaining low rates of hospital acquired Clostridium Difficile and MRSA bacteraemia.

  • Number of falls down 8%*****.

 

While these figures demonstrate that the Trust is heading in right direction, Chief Executive Kevin McGee urged caution: “We are obviously pleased with the improvements in mortality rates and it is testament to the efforts of all our staff, but we are still some distance from where we want to be. We always knew this wasn’t going to be a quick fix; this is very much a journey, both for the Trust and the wider health economy.

“Securing a strategic partner for the organisation will be part of this journey, ensuring services and high quality care remain sustainable in the long-term.

“Mortality rates act as a ‘warning sign’ that there are problems in the system. As we have analysed what is behind our historic mortality rates, a complex picture has emerged about the quality of care, the way we manage information, the broader public health picture for local people and long-term healthy lifestyle strategies that need to be implemented in partnership with the wider health economy.

“We still have a long way to go, but early signs are that we are on the road to transforming health services ensuring that moving forward we can provide sustainable, high-quality services that meet the needs of our local population and in which they can have confidence in.”

Professor Chris Welsh, Medical Director of NHS Midlands and East, added: “I am pleased to see that George Eliot Hospital’s mortality rates have shown an improvement in recent months.

“The trust recognises that there is a need to improve further, and I am confident that they are taking actions to address the reasons for their higher-than-average mortality rates. We will continue to work with the trust to improve their mortality rates so that they can maintain their good progress so far.”

 

Notes:
  • *The SHMI figure of 1.16 reported in October 2012 represents performance between April 2011-March 2012. The figure of 1.21 reported in October 2012 represented performance between April 2010-March 2011. For more details on SHMI please go to http://www.ic.nhs.uk/services/summary-hospital-level-mortality-indicator-shmi

  • **The external review, which began in November, identified four key areas for improvement:

  • Continuity of care: Particularly in relation to the way some inpatients experience too many moves between different wards and change of responsible consultant, leading to potential risks from inconsistencies in care.
  • Patient flow: As well as appropriate place of care within the hospital, there need to be better pathways for patients to and from primary/community care and the hospital.  This requires the involvement of other health and care organisations to work with the hospital to help prevent unnecessary admissions to hospital and improve timely discharge.
  • Information management:  The Trust has a clear need to improve its information management systems to support clinical and managerial decision-making and to dramatically improve the recording of patient information which can impact the way mortality rates are calculated.
  • Impact of external factors on GEH mortality figures: Better support is needed for end-of-life care in the community by other health and care providers, along with greater integration between GEH and other healthcare partners to provide seamless access to services and to improve healthy living, health outcomes and reduce health inequalities within the local community.
  • ***The Trust has been shortlisted in the ‘Care of the Elderly’ category at the Nursing Times Awards 2012 – click here for more information.

  • ****The Trust was awarded ‘excellent’ in all three categories of the annual Patient Environment Action Team (PEAT) inspection – click here for more information

  • *****Number of patient falls have fallen 8% - this is the current year to date figure compared to the same period in 2011/12.

 

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