The Reality Behind Mortality of Our Hospital Inpatients

At Hudson Hospital & Clinic, the care team's experience within a small critical access hospital revealed a concerning discrepancy: real mortality rates were being underreported. Consequently, accurate targets for prognostication and quality improvement initiatives became unreliable. Upon assessing a sample of general medical inpatients throughout the calendar year 2022, significant findings emerged. Notably, 28% of deaths were not documented in the electronic health record. Furthermore, a nine-month mortality rate was found to be correlated with readmission rates, length of stay, and the patient's disposition prior to death. To address this discrepancy, the team delved into the root causes and developed their own trigger thresholds. These thresholds were designed to prompt meaningful discussions regarding goals of care and thoughtful planning for patient dispositions.