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Treatment checklists cut deaths by 15%

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Treatment “checklists” have led to a 15 per cent reduction in patient deaths in three hospitals, research has shown.

The aim of the lists is to cut down the number of avoidable deaths and to improve patient care.

Each printed list - also known as a care bundle - includes details of best practice treatment, such as when to administer antibiotics, the types of blood samples needed or the optimum level of oxygen saturation in the blood.

Some 7 per cent of hospital admissions result in something going wrong (an adverse event), of which about 8 per cent cause death.

Around half of adverse events are avoidable, research has shown.

In the latest study, the North West London Hospitals Trust implemented eight care bundles known to help reduce risks for patients.

The bundles covered 13 diagnostic areas with the highest number of deaths at the trust in 2006-07, including stroke, heart failure and chronic obstructive pulmonary disease.

The trust serves about 500,000 people at three hospital sites: Northwick Park Hospital, Central Middlesex Hospital and St Mark’s Hospital.

Researchers looked at the effect of the bundles on the hospital’s standardised mortality ratio.

An HSMR of 100 equates to the same risk of death as the English national average, while 120 equates to 20 per cent above the national average and 80 to 20 per cent below.

After the care bundles were introduced, the trust’s HSMR fell from 89.6 in 2006-07 to 71.1 in 2007-08 - the lowest among acute trusts in England.

Overall, 255 fewer deaths occurred (174 of these in the targeted diagnoses) than if the 2006-07 death rates applied.

The researchers said their methods could be used to reduce death rates in other hospitals.

Writing in the British Medical Journal, they said: “Implementing care bundles can lead to reductions in death rates in the clinical diagnostic areas targeted and in the overall hospital mortality rate.”

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