Mortality Review Committee: Understanding Inpatient and 30-Day Mortality at a Comprehensive Cancer Center.

Area of Science:

• Healthcare Quality Improvement
• Patient Safety
• Palliative Care

Background:

• The Triple Aim emphasizes improving care experience, population health, and reducing costs.
• Institutions are implementing quality improvement initiatives to enhance patient care.
• Reviewing inpatient mortality is crucial for identifying systemic issues and improving care delivery.

Purpose of the Study:

• To report the experience and impact of establishing a Mortality Review Committee (MRC).
• To identify learning and improvement opportunities in inpatient and 30-day hospital mortalities.
• To assess the association between goals of care discussions and identified improvement opportunities.

Main Methods:

• Formation of an interdisciplinary MRC in April 2022 to review inpatient and 30-day mortality cases.
• Characterization of each mortality case for learning and/or improvement opportunities.
• Analysis of patient data, including prior goals of care discussions and palliative care visits.

Main Results:

• Patients with prior goals of care discussions had significantly fewer learning opportunities (29% vs. 51%).
• Patients with palliative care visits also had fewer learning opportunities (37% vs. 48%).
• The frequency of goals of care conversations remained stable, but hospice referrals increased.

Conclusions:

• The MRC facilitated interdisciplinary communication to improve care for patients experiencing mortality.
• Focus shifted towards earlier goals of care discussions and shared decision-making.
• The committee fostered a cultural integration of advanced care and end-of-life planning earlier in treatment.