500 Lives October 2015 Mark Juniper 500 lives calculation: 2012 - - PowerPoint PPT Presentation

“500 Lives” October 2015

Mark Juniper

60 70 80 90 100 110 120 130 140 Apr-12 May-12 Jun-12 Jul-12 Aug-12 Sep-12 Oct-12 Nov-12 Dec-12 Jan-13 Feb-13 Mar-13 Apr-13 May-13 Jun-13 Jul-13 Aug-13 Sep-13 Oct-13 Nov-13 Dec-13 Jan-14 Feb-14 Mar-14 Apr-14 May-14 Jun-14 Jul-14 Aug-14 Sep-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15

2012 to 2015 Mortality Trends - Actual & HSMR

Overall Trust Deaths Dr Foster Mortality HSMR Relative Risk - GWH Trust

500 lives calculation:

Current data (June 2014-May 2015 – Dr Foster):

• Patient spells 16242
• Expected deaths 7.05% = 1138
• Observed deaths 6.23% = 1006
• Expected – observed = 132

Similar work:

• IHI
• NHS Wales
• Salford hospitals

Principles:

Harm free care Evidence based best practice Standardising processes Reducing variation Improvement methodology Measurement Outcome Processes

Our plan: To save 500 EXTRA lives….

NHS England campaign which aims to:

• Reduce avoidable harm by 50%
• Save 6000 lives in England over the next five years

GWH workstreams: Falls Pressure Ulcers Sepsis Acute Kidney Injury Deteriorating Patients

Sepsis:

Aim Reduce (30 day) mortality from severe sepsis to 23% by 2017 Data collection for:- Outcome measure – mortality from sepsis Process measures – antibiotics administered within 60 minutes

• use of sepsis 6 care pathway

AKI:

Aim: Reduce avoidable AKI by 20% Outcome measures: % of patients with avoidable AKI, inpatient AKI bed days Process measures: TBC – Use of AKI Care bundle, AKI follow up requirement on discharge summaries(CQUIN)

Deteriorating Patients

Outcome measure 1 – inpatient cardiac arrests per 1000 bed days

• Secondary Drivers – Standardised EWS (NEWS) and DNAR (TEP)
• Process measures

% of patients with NEWS completed % of patients with appropriate escalation Note: electronic recording of observations removes human factors and has reduced mortality by 10-20% in other organisations Aim- To reduce in hospital cardiac arrests: 10% reduction each year in the rate of in hospital cardiac arrests

0.5 1 1.5 2 2.5 Jan-13 Feb-13 Mar-13 Apr-13 May-13 Jun-13 Jul-13 Aug-13 Sep-13 Oct-13 Nov-13 Dec-13 Jan-14 Feb-14 Mar-14 Apr-14 May-14 Jun-14 Jul-14 Aug-14 Sep-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Cardiac arrests per 1000 Bed Days Median

Other opportunities:

Emergency laparotomy Catheter associated UTI Hip fracture care Enhanced recovery surgery (?medicine) Delirium Surgical complications Other.