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The Mayo Clinic Hospital Mortality Reduction Project: Description and Results
Jeff T Mueller1, Kay M B Thiemann, Cynthia Lessow
1associate dean for hospital practice, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, Arizona assistant professor, healthcare systems engineering, Mayo Clinic College of Medicine, Jacksonville, Florida quality performance analyst, Mayo Clinic, Phoenix, Arizona professor of medicine, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota associate professor, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota associate dean for value creation, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota; and chair, Quality and Affordability Administration, Mayo Clinic, Rochester, Minnesota.
A multicomponent intervention successfully reduced hospital inpatient mortality by 14% across a multistate healthcare system. This quality improvement initiative focused on care redesign to improve patient outcomes and reduce observed/expected mortality ratios.
Area of Science:
- Healthcare quality improvement
- Clinical outcome measurement
- Hospital administration
Background:
- Healthcare organizations utilize diverse definitions of hospital mortality for quality assessment.
- An observed upward trend in mortality prompted an investigation into potential interventions.
- Limitations of hospital-wide mortality as a quality improvement metric influenced the study design.
Purpose of the Study:
- To evaluate a multicomponent intervention designed to decrease inpatient mortality.
- To implement standardized system-wide improvements alongside site-specific practice redesign.
- To address a statistically nonsignificant upward trend in the observed/expected mortality ratio.
Main Methods:
- Prospective evaluation of a multicomponent intervention in a multistate healthcare system.
- Implementation of standardized system-wide improvements and site-specific practice redesign.
- Monitoring of system-wide mortality rates from Q3 2015 to Q4 2017.
Main Results:
- System-wide inpatient mortality decreased from 1.78 to 1.53 per 100 admissions.
- The observed/expected mortality ratio showed a statistically significant reduction (p = .01).
- The intervention demonstrated effectiveness in reducing overall hospital mortality.
Conclusions:
- A focused care redesign intervention can significantly reduce inpatient mortality.
- Standardized system-wide improvements combined with site-specific initiatives are effective.
- The study provides a model for other healthcare systems aiming to improve mortality outcomes.
