I was recently shown some risk-adjusted mortality data from the University HealthSystem Consortium comparing actual versus predicted mortality for Hopkins Hospital. Looking at risk categories from low-risk patients to high-risk patients, Hospital patients had lower than expected mortality in all of these groupings. I have been told that our Hospital scored among the best—number 2—among all 81 academic medical centers in the cohort for these statistics.
Congratulations. This appears to be a great accomplishment, and if in subsequent years we can establish similar results to prove that 2005 was not a statistical fluke, we can certainly take pride in these results.
It’s important to observe that, assuming these results can be consistently reproduced, it’s as yet unclear why we are doing better than other hospitals. Perhaps it’s due to the superior quality of physician and nursing expertise—and in particular clinical skills—which seem to be in such short supply these days. On the other hand, perhaps our initiatives in patient safety are paying off in ways we didn’t foresee. Many safety and quality improvement initiatives set very specific goals, such as reducing infection rates, that weren’t necessarily focused specifically on mortality outcomes.
But whatever we learn, what I do feel after looking at the data is that we could set audacious targets for mortality goals and use our patient safety initiatives as an appropriate tool to reach those goals. From a quick glance at our results, we’re not far from achieving actual mortality that is just 60 percent of “expected” mortality, and so a 50 percent or even 40 percent target could represent a reasonable “stretch” goal. The implications of this are rather startling. Imagine if we could demonstrate that the mortality for patients coming to Hopkins Hospital was fully half that of most other hospitals.
This goal is, in my view, within our reach. If we simply unleash the creative energy of our staff, from doctors and nurses to ward clerks, housekeepers, pharmacists, technicians and administrators, we can do this.
I salute everyone in the Johns Hopkins Health System for these unparalleled accomplishments. Please join me in considering how, in the year ahead, we can move the bar of excellence even higher.
