Background: Structured mortality review can help identify care issues and focus quality efforts, but existing methods have limitations. In the Department of Medicine at UCLA, we developed a novel in-person, near real-time, interdisciplinary rapid mortality review (RMR) process to capture the insight of frontline providers and improve care. In this study, we compare the yield [...]

Background: Structured mortality review can help identify care issues and focus quality efforts, but existing methods have limitations. In the Department of Medicine at UCLA, we developed a novel in-person, near real-time, interdisciplinary rapid mortality review (RMR) process to capture the insight of frontline providers and improve care. In this study, we compare the yield [...]

Background: The UCLA Department of Medicine (DOM) Rapid Mortality Review (RMR) is an innovative in-person, near real-time review of all deaths to capture the unique insight of the care providers into aspects of end-of-life care quality that otherwise go undocumented and unreported. The purpose of this study is to examine characteristics of mortality cases that [...]

Background: Mortality is the first quality metric reported by CMS, and historically a key measure for evidence based medicine since the 1800’s. THINK:  John Snow removing the handle from the Broad street well pump to reduce cholera deaths  Ignaz Semmelweis demonstrating washing hands reduced puerperal fever and death. Mortality rates are risk adjusted [...]

Background: Traditional review approaches to inpatient mortality remain flawed. M&M conferences, administrative data analysis, and chart review do not effectively leverage the frontline perspective, are frequently delayed, and may be perceived as punitive if not peer review protected. Purpose: We developed an electronic mortality review tool that would: (1) permit rapid review of all inpatient [...]

Background: Capturing appropriate clinical documentation allows providers to best approach treating patients and can also be utilized for quality monitoring of outcomes within health systems. Mortality measures are used by the Centers for Medicare and Medicaid Services (CMS) for reimbursement and payment. (1) Observed mortality includes all deaths which occur in the hospital during a [...]