Hutchinson, A., Coster, J.E. orcid.org/0000-0002-0599-4222, Cooper, K.L. orcid.org/0000-0002-7702-8103 et al. (3 more authors) (2013) A structured judgement method to enhance mortality case note review: development and evaluation. BMJ Quality and Safety, 22 (12). pp. 1032-1040. ISSN 2044-5415
Abstract
Background: Case note review remains a prime means of retrospectively assessing quality of care. This study examines a new implicit judgement method, combining structured reviewer comments with quality of care scores, to assess care of people who die in hospital. Methods: Using 1566 case notes from 20 English hospitals, 40 physicians each reviewed 30–40 case notes, writing structured judgement based comments on care provided within three phases of care, and on care overall, and scoring quality of care from 1 (unsatisfactory) to 6 (very best care). Quality of care comments on 119 people who died (7.6% of the cohort) were analysed independently by two researchers to investigate how well reviewers provided structured short judgement notes on quality of care, together with appropriate care scores. Consistency between explanatory textual data and related scores was explored, using overall care score to group cases. Results: Physician reviewers made informative, clinical judgement-based comments across all phases of care and usually provided a coherent quality of care score relating to each phase. The majority of comments (83%) were explicit judgements. About a fifth of patients were considered to have received less than satisfactory care, often experiencing a series of adverse events. Conclusions: A combination of implicit judgement, explicit explanatory comment and related quality of care scores can be used effectively to review the spectrum of care provided for people who die in hospital. The method can be used to quickly evaluate deaths so that lessons can be learned about both poor and high quality care.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2013 BMJ Publishing Group. This is an author produced version of a paper subsequently published in BMJ Quality and Safety. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | Chart review methodologies; Healthcare quality improvement; Patient safety; Qualitative research; Quality improvement methodologies |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) > ScHARR - Sheffield Centre for Health and Related Research The University of Sheffield > Faculty of Social Sciences (Sheffield) > Information School (Sheffield) |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 06 May 2016 09:32 |
Last Modified: | 06 May 2016 09:34 |
Published Version: | http://dx.doi.org/10.1136/bmjqs-2013-001839 |
Status: | Published |
Publisher: | BMJ Publishing Group |
Refereed: | Yes |
Identification Number: | 10.1136/bmjqs-2013-001839 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:96911 |