Quick, in-person meetings to review intensive care unit deaths can be an effective tool to improve care quality in the ICU, according to a study published in the American Journal of Critical Care.
Clinicians at the Ronald Reagan University of California Los Angeles Medical Center piloted a multidisciplinary rapid mortality review process in 2013. The program entailed regular meetings in which staff members reviewed each patient death in the ICU and discussed whether the death could have been prevented or if any aspects of care could have been improved. After each meeting, a summary of the discussion was recorded in an electronic database so quality leaders could review the information and implement changes, as needed.
By 2018, the hospital's rapid mortality review team had analyzed 542 patient deaths, 7 percent of which were deemed potentially avoidable. Leaders identified issues in 54 percent of cases, ranging from communication problems and care delays to medical errors. They also recommended action items after reviewing 32 percent of cases. Nearly two-thirds of these action items — such as creating a standardized checklist for inbound patient transfers — were completed, and 11 percent led to tangible systemic changes at the hospital.
"Our findings suggest that these short and timely in-person meetings can be a powerful tool for efforts to both improve quality and prevent mortality in the ICU," lead author Kristin Schwab, MD, a pulmonologist and critical care physician at UCLA Health, said in a news release. "Bringing members of the multidisciplinary care team together for regular face-to-face discussions provided a forum that revealed concerns and solicited tangible ideas for solutions."
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