Kill the Mortality - Building Successful Inpatient Mortality Reduction Programs in Academic and Rural Health Systems-Slides

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The presentation "Kill the Mortality" by Dr. Shyam Odeti and Dr. Mangla Gulati focuses on building successful inpatient mortality reduction programs in academic and rural health systems. It highlights the impact of mortality metrics on quality programs, methodologies for evaluating mortality, and multidisciplinary strategies for reduction involving hospitalists.<br /><br />Key concepts include understanding Severity of Illness (SOI), Risk of Mortality (ROM), and Observed-to-Expected (O/E) mortality ratios, where ratios below 1 indicate better-than-expected performance. The presentation discusses how mortality figures prominently in quality rating systems like CMS Stars, Leapfrog Safety Grades, and Vizient benchmarking, affecting pay-for-performance and value-based purchasing programs.<br /><br />Carilion Clinic and Medstar Washington Hospital Center exemplify the application of these programs across various hospital types, including academic Level 1 trauma centers and rural hospitals. The role of hospitalists in documenting patient severity ("my patient is sicker" documentation) is emphasized for accurate risk adjustment and resource allocation.<br /><br />Case examples of COPD/pneumonia and complicated UTI/sepsis illustrate how precise coding and clinical documentation improve the capture of comorbidities (CC/MCC) influencing severity and reimbursement. A real-time, multidisciplinary mortality review committee applies a just culture framework to identify system failures without assigning blame, promoting continuous quality improvement.<br /><br />Programmatic interventions include enhanced documentation practices, sepsis mortality reviews, implementation of AI-powered deterioration indices for early intervention, and improving transitions to hospice/general inpatient palliative care. The presentation discusses nuances such as observation status and its financial/patient impact versus inpatient admission.<br /><br />Results show significant mortality reductions across hospitals from FY22 to FY23, using Vizient benchmarks and quality plan goals. The presenters underscore the importance of leveraging electronic health records, AI, coding collaboration, and multidisciplinary efforts to sustainably reduce inpatient mortality and enhance patient outcomes.<br /><br />Contact details and CME evaluation instructions conclude the presentation.

Keywords

Inpatient Mortality Reduction

Severity of Illness (SOI)

Risk of Mortality (ROM)

Observed-to-Expected (O/E) Mortality Ratios

Quality Rating Systems

Hospitalist Documentation

Comorbidity Coding (CC/MCC)

Multidisciplinary Mortality Review

AI-Powered Deterioration Indices

Value-Based Purchasing