SHM Converge Scientific Abstract ePoster Gallery-Improving Mortality Index for Solid Malignancy Service Through a Hospitalist and Oncologist Collaborative Interprofessional Mortality Review

Improving Mortality Index for Solid Malignancy Service Through a Hospitalist and Oncologist Collaborative Interprofessional Mortality Review

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This report describes a collaborative mortality review program designed to improve the Mortality Index (MI) on a hospitalist-run solid oncology service. Mortality review is important for assessing quality of care, identifying opportunities for improvement, and supporting accurate reimbursement. MI compares observed deaths with expected deaths, and expected mortality depends heavily on how well patient illness severity and comorbidities are documented.<br /><br />A multidisciplinary committee was created with oncology hospitalists, a bone marrow transplant hospitalist, an oncologist, and representatives from coding and clinical documentation improvement (CDI). Before each monthly meeting, randomly assigned physicians reviewed mortality cases for both clinical and documentation opportunities. Reviewers used a mortality risk calculator and Vizient variables, and findings were recorded in Redcap. During meetings, the group discussed documentation gaps; when appropriate, CDI sent queries to capture additional variables, and if queries were not possible, CDI and coding explained what should have been documented.<br /><br />The program was associated with a marked improvement in MI. Average MI improved from 1.030 before the review process to 0.523 afterward. This change was driven primarily by an increase in expected mortality, which rose from 3.778 to 5.05, rather than by a decrease in observed mortality. The authors conclude that interprofessional mortality review, especially collaboration among hospitalists, oncologists, CDI, and coding, can improve documentation, better capture patient complexity, and increase the accuracy of mortality metrics. They also note that this model is practical and can be replicated at other institutions, with hospitalists playing a key leadership role in quality improvement.

Asset Subtitle

Evan Nardone

Meta Tag

Author List Ashley Traczuk, Evan Nardone, Suchit Bhutani

Category Research

Concept Mortality Review

Concept Mortality Metrics

Concept Observed Mortality

Concept Expected Mortality

Concept Quality of Care

Distinguished Non-Finalist

Presenter Organization Thomas Jefferson University

Presenting Author Evan Nardone

Track Quality Improvement

Keywords

mortality review

mortality index

hospitalist

solid oncology

clinical documentation improvement

coding

expected mortality

observed mortality

quality improvement

interprofessional collaboration

Mortality Review

Mortality Metrics

Observed Mortality

Expected Mortality

Quality of Care