Centre for Primary Care Seminar Series - 'What do we really know about preventable deaths? Implications for learning from errors, ranking hospitals and the use of standardized mortality rates'
|Starts:||13:00 9 Oct 2018|
|Ends:||14:00 9 Oct 2018|
|What is it:||Seminar|
|Organiser:||Faculty of Biology, Medicine and Health|
|Who is it for:||University staff|
|Speaker:||Professor Timothy Hofer|
Most assessment of the quality of care received by patients who die is carried out by indirect measurement using standardized mortality rates (SMRs) now widely used across the developed world. Yet the entire premise for doing so depends on the assumption that given the risk adjustment model, differences in the SMRs across hospitals will reflect potentially avoidable or preventable deaths which in turn result from differences in quality of care. Direct measurement of preventable deaths by expert review represents one of the only ways to validate the fundamental assumption of using SMRs to measure quality of care. It also remains the only method in current use when attempting to identify whether any given death was preventable so as to learn from any mistakes through methods such as root cause analysis, or for use in decisions about legal and financial restitution. Given some of the lingering concerns about the validity of SMRs as a measure of quality and interest in learning from adverse events, the National Health Service in England has recently considered an operational system of measuring and monitoring preventable deaths.
This talk will describe what we know from the literature about the measurement of preventable deaths as assessed by expert physician judgement following review of medical records and then focus on the implications of those findings for designing an operational or research program to use the measurements to monitor or assess quality of care. The conclusions have significant implications for policy and practice related to measuring quality of care, preventable mortality and use of SMRs as a measure of hospital care provision.
Dr. Timothy Hofer is Professor of Medicine at the University of Michigan Medical School and the Associate Director for Analytic and Information Resources at the VA Center for Practice Management and Outcomes Research in Ann Arbor as well as a member of the UM Institute for Healthcare Policy and Innovation. He is currently visiting the Universities of Birmingham and Warwick, working with Professor Richard Lilford's group.
His work broadly focuses on measuring and improving quality of care in the complex patient. He is interested in the methodological and practical issues in measuring and profiling quality of care and how the ability to measure quality may affect popular policy initiatives to identify and reduce medical errors or set up pay for performance systems. His projects have focused on the adequacy of risk adjustment, social and economic factors predicting utilization, as well as the patient, provider and organizational influences on performance measurement and indicators.
Professor Timothy Hofer
Role: Professor of Medicine at the University of Michigan Medical School
Organisation: University of Michigan
Travel and Contact Information
Seminar Room, Fifth Floor