Document Type : Original Article
1 Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, Valencia, Spain
2 Preventive Medicine and Occupational Risk Prevention Services, University General Hospital of Valencia, Valencia, Spain
3 Nursery College, Universidad de Valencia, Valencia, Spain
Background: Avoidable mortality (AM) is one of the most important health indicators (HI) and represents the quality of care in a hospital.
Objective: This study measured the efficacy of a training program for a hospital healthcare staff to reduce AM.
Methods: This epidemiological study on community intervention analyzed time-series data on HI by semesters from 2008 to 2015. The pre-intervention phase was examined from January 2008 to December 2014; the intervention phase was investigated in the first semester of 2015; and the post-intervention phase was examined in the second semester of 2015.
Results: Resindicate a series with a rising tendency until the 14th semester and a pronounced descent in the 16th semester. The relative variation rate (RVR) was -20% to +20% with some exceptions. HI was 0.53% in the 16th semester rather than the expected 0.70% observed in the pre-intervention phase; therefore, 0.17% additional deaths were avoided because of the training seminar.
Conclusion: The positive results suggest that this strategy is an important element in decreasing avoidable deaths in hospitals.
- Rutstein DD, Berenberg W, Chalmers TC, Child CG, Fishman AP, Perrin EB. Measuring the quality of medical care. A clinical method. N Engl J Med. 1976;294:582-588.
- Charlton JR, Hartley RM, Silver R, Holland WW. Geographical variation in mortality from conditions amenable to medical intervention in England and Wales. Lancet. 1983;1:691-696.
- Charlton JR, Velez R. Some international comparisons of mortality amenable to medical intervention. Br Med J (Clin Res Ed). 1986;292(6516):295-301.
- Holland W. European Community Atlas of Avoidable Death. Oxford: Oxford University Press; 1988.
- Holland W. Avoidable death as a measure of quality. Qual Assur Health Care. 1991;2:227-233.
- Benavides FG, Orts R, Perez S. Adding years to life: effect of avoidable mortality on life expectancy at birth. J Epidemiol Community Health. 1992;46:394-395.
- Gispert R, Torne MD, Arán BM. The efficiency of the Health System in Spain. Gac Sanit. 2006;20 Suppl 1:117-126.
- Melchor I, Nolasco A, Garcia-Senchermes C, et al. Avoidable mortality. Changes in the new century? Gac Sanit. 2008;22:200-209. doi:10.1157/13123965.
- EC Working Group on Health Services and “Avoidable Deaths”. European Community Atlas of “Avoidable Death”. 1991.
- Moauro F, Savio G. Temporal disaggregation using multivariate structural time series models. Econom J. 2005;8(2):214-234.
- Beck N, Katz JN. What to do (and not to do) with time-series cross-section data. Am Polit Sci Rev. 1995;89(3):634-647.
- Crighton EJ, Muhammad MM, Ross EG. A population based time series analysis of asthma hospitalisations in Ontario, Canada: 1988 to 2000. BMC Health Serv Res. 2001;1:7. doi:10.1186/1472-6963-1-7.
- Gisele CM. Pronósticos de mortalidad por enfermedades no transmisibles seleccionadas. Rev Cubana Hig Epidemiol. 2008;46(3).
- Martínez NF. Vigilancia Epidemiológica. 1st ed. Madrid: McGraw-Hill Interamericana; 2004:104
- Aibar C, Aranaz J. Can adverse effects related to hospital treatment be avoided? An Sist Sanit Navar. 2003;26(2):195-209.
- Aranaz JM, Aibar C, Galan A, et al. Health assistance as a risk factor: side effects related to clinical practice. Gac Sanit. 2006;20:41-7. doi: 10.1157/13086025.
- Kuhn AM, Younberg BJ. The need for risk management to evolve to assure a culture of safety. Qual Saf Health Care. 2002;11:158-62. doi:10.1136/qhc.11.2.158.
- Otero LM. Errores de medicación y gestión de riesgos. Rev Esp Salud Publica. 2003;77:527-40.
- Institute of Medicine. To Err Is Human: Building a Safer Health System. Washington DC: National Academy Press; 1999. http://www.csen.com/err.pdf.
- American Society for Healthcare Risk Management. Strategies and tips for maximizing failure mode and effect analysis in an organization. J Healthc Risk Manag. 2002;22:9-12. doi:10.1002/jhrm.5600220304.
- McDonough JE. Proactive hazard analysis and health care policy. New York: Milbank Memorial Fund; 2002. http://www.milbank.org/reports/HazardAnalysis.pdf.
- Habraken MP, Van der Schaaf TW, Leistikow IP, Reijnders-Thijssen MJ. Prospective risk analysis of health care processes: a systematic evaluation of the use of HFMEA in Dutch health care. Ergonomics. 2009;52:809-819. doi:10.1080/00140130802578563.