Care Bundles May Decrease In-Hospital Mortality

Before-and-after study shows implementation reduces deaths in targeted diagnoses
By Rick Ansorge
HealthDay Reporter

FRIDAY, April 2 (HealthDay News) -- Implementing care bundles may significantly reduce in-hospital mortality, according to a report published online April 1 in BMJ.

Elizabeth Robb, R.N., of the North West London Hospitals NHS Trust, and colleagues implemented eight care bundles of treatments at an acute hospital trust and compared adjusted mortality to the previous year for 13 diagnoses targeted by the care bundles, 43 non-targeted diagnoses, and overall mortality for the 56 hospital standardized mortality ratio diagnoses covering 80 percent of hospital deaths.

After care bundle implementation, the researchers observed significant decreases in the standardized mortality ratio of the targeted diagnoses and the hospital standardized mortality ratio, along with a small decrease in the non-targeted diagnoses. They found that the hospital standardized mortality ratio decreased from 89.6 in 2006/2007 to 71.1 in 2007/2008, which they stated was the lowest among acute trusts in England. There were also significant reductions of standardized mortality ratios in 11 of the 13 diagnoses targeted, compared with the previous year.

"The methods described in this study, of determining the main causes of death in a hospital trust and then using methods of treatment (care bundles) developed from evidence of their effectiveness, to reduce mortality in the targeted diagnostic areas could be generally applicable," the authors conclude.

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