Hospital Dr News

New review approach to deaths enables NHS hospitals to learn the lessons

A new standardised review approach to acute deaths is enabling hospitals to learn and improve patient care.

That’s the conclusion of a landmark report by the Royal College of Physicians, which says the Structured Judgement Review (SJR) offers insight into the care delivered to adult patients before death in a way that data from clinical coding and death certification cannot.

The RCP’s National Mortality Case Record Review Programme (NMCRR), commissioned by the Healthcare Quality Improvement Partnership, developed the SJR process to replace the variable local systems with a standardised, national, evidence-based method.

SJRs maximise the potential for learning and improvement and encourage the development of quality improvement initiatives when problems in care are identified.

Importantly SJRs also help identify good practice for sharing within the NHS.

The NMCRR programme has been implemented in over 100 NHS trusts and health boards across England and Scotland since 2016.

The NMCRR programme team has trained around 480 healthcare professionals across England and Scotland, who in-turn have shared their training with at least 1500 other healthcare professionals including doctors and nurses.

The report cites a number of case studies where the SJR has made positive contributions to improving healthcare for patients.

For example, Buckinghamshire Healthcare NHS Trust introduced medical examiners and the SJR process to screen all deaths in 2017.

Within just six months 97% of deaths were screened and 12% of all cases used the SJR process.

This has resulted in:

  • informing improvements in end of life (EOL) care including promoting patient choice
  • encouraging formulation of personalised care plans in the hospital and the community
  • improved sepsis recognition and treatment
  • increased awareness of timely Do Not Attempt CPR (DNACPR) decisions and treatment escalation plans (TEP).

Dr Andrew Gibson Consultant Neurologist, clinical lead for the NMCRR, said: “This pioneering NMCRR programme aims to implement a validated, standardised way of reviewing the case records of adults who died in hospitals across England and Scotland.

“The report demonstrates that through using a standardised review approach NHS trusts can successfully improve quality in patient care and safety. It also highlights the significant efforts required to implement the programme nationally and the enthusiasm from those involved to work collaboratively.”

Read more.

Bookmark and Share

Post a Comment

Enter this security code

Submit Comment for Moderation