Mortality Ratio

The mortality ratio is quality data that compares patients’ actual vs. expected death rates, based on patients’ illnesses.

Mortality ratio = Observed mortality / Expected mortality

• The observed mortality is the number of patient deaths that occur in the hospital for any reason.
  
  
• The expected mortality is the predicted number of deaths in the hospital based on the hospital's patients' levels of illness. Patients who are very sick (higher severity of illness) have a higher expected mortality rate. The expected mortality rate does not reflect a hospital's quality of care. If two hospitals had patients with exactly the same severity of illnesses, the hospitals' expected mortality rates would be the same.
  
  Many children admitted to Lucile Packard Children's Hospital are very sick. They have complicated medical conditions that increase the chances that they will die (their expected mortality) – their survival is less likely than for less sick children. Example: A baby born three months premature is sicker and has a more complicated medical condition than a patient with a broken leg. So, the premature baby has a higher expected mortality. 
  
  
• The standard ratio of 1.0 indicates that the observed mortality rate equaled the expected mortality rate based on patients’ level illness.  A mortality ratio under 1.0 means that more patients survived than were expected due to the severity of their illnesses.

A low score is better than a high score. A lower score means more patients survived than were expected due to the severity of their illnesses.

Packard Children's mortality ratio only includes pediatric patients. It does not include obstetric patients. 

Mortality Ratio January 2010-December 2010

Last Updated: March 2011

Benchmark data is the average mortality ratio for university-based children’s hospitals collected by the Child Health Corporation of America Pediatric Health Information Systems (PHIS).
 
What This Graph Says
Packard Children’s Hospital’s mortality ratio between January 2010-December 2010 was 0.53 (blue bar). This means that more patients survived than were expected due to the severity of their illnesses.
Packard Children’s Hospital cares for some of the sickest children in the country and we maintain positive outcomes compared to other children’s hospitals that see less sick children. Our mortality ratio is significantly below the average mortality ratio of other children’s hospitals of 0.82 (red bar). It is significantly better than the standard (green bar) where observed mortality equals expected.
 

Mortality Ratio Trended Over Time

 
Last Updated: March 2011

Benchmark data is the average mortality ratio for university-based children’s hospitals collected by the Child Health Corporation of America Pediatric Health Information Systems (PHIS).

What This Graph Says
This graph shows mortality ratios for the past three years. Packard Children’s Hospital (blue bar) is consistently significantly better than the benchmark (red bar) and significantly better than the standard (purple bar) where observed mortality equals expected. Packard Children’s Hospital cares for some of the sickest children in the country and we maintain positive outcomes compared to other children’s hospitals that see less sick children.  

What We Are Doing to Improve the Mortality Ratio

Examples of projects underway to improve the mortality ratio at Packard Children’s Hospital include:

• Implementing Rapid Response Teams. Rapid Response Teams are highly specialized critical care teams consisting of physicians, nurses and respiratory therapists. They work 24x7 to proactively evaluate patients whose symptoms suggest the possibility that a “code” that might happen shortly. The teams determine if immediate medical intervention is needed to prevent this code from occurring.
  
  Packard Children’s Hospital has been recognized for its Rapid Response Teams nationally and internationally by:
  • Being awarded the Child Health Corporation of America's (CHCA) 2007 RACE for Results award for its success in implementing Rapid Response Teams
  • Publishing a paper in the Journal of the American Medical Association (JAMA) in November 2007
    
    
• Implementing Computerized Provider Order Entry (CPOE). CPOE is a computerized system that allows direct entry of medical orders by a licensed health care provider. Entering orders directly into a computer:
  • Reduces errors due to poor handwriting
  • Ensures accurate drug ordering
  • Identifies drug allergies
  • Improves quality and efficiency of health care delivery

Packard Children's Hospital was recognized for its CPOE implementation nationally and internationally with the paper it published in Pediatrics in May 2010.

• Reducing surgical site infection rates. We follow the best practices recommended by the Institute for Healthcare Improvement (IHI) and the Centers for Disease Control and Prevention. We are part of a national collaboration of approximately 20 children’s hospitals that follows these practices.
  
  
• Reducing catheter associated bloodstream infections (CABSI). We have implemented the recommendations from the Institute for Healthcare Improvement (IHI) Prevention of Central Line-Associated Bloodstream Infection campaign. You can also learn more about our CABSI infection rates.