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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.


Mortality Ratio
January 2007-December 2007

Lower is better Graph of mortality ratio from July 2006 to June 2007
Last Updated: April 4, 2008
Benchmark = Average mortality rate for similar university-based children’s hospitals collected by the University HealthSystem Consortium
 
What This Graph Says
Our mortality ratio is excellent, particularly given the number of high risk, very sick patients at Packard Children’s Hospital. Packard Children’s Hospital’s mortality ratio between January 2007–December 2007 was 0.66 (blue bar).
 
Our mortality ratio is near the benchmark of 0.53 (orange bar). We are right around the national average of other university-based children's hospitals.
 
The observed to expected mortality ratio for Lucile Packard Children's Hospital only includes pediatric patients. It does not include obstetric patients. The graph also shows the standard ratio (purple bar) for comparison.


Mortality Ratio Trended Over Time

Lower is better Graph of mortality ratio trended over time
Last Updated: April 4, 2008
Benchmark = Average mortality rate for similar university-based children’s hospitals collected by the University HealthSystem Consortium
 
What This Graph Says
This graph shows mortality ratios for the past two years. Packard Children’s Hospital (blue bar) has consistently performed at or around the benchmark (orange) and significantly better than the standard (purple) where observed mortality equals expected.
 
Packard Children's mortality ratio only includes pediatric patients. It does not include obstetric patients.


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. Physicians, nurses and respiratory therapists work 24x7 to proactively evaluate patients whose symptoms indicate a possible life-threatening event. The teams determine if immediate medical intervention is needed to prevent the life-threatening event. This quick response to a patient’s changing condition has led to a(n):
    • 80 percent decrease in cardiorespiratory arrests outside of the intensive care unit (ICU) setting
    • 17 percent decrease in mortality across the entire hospital. Lucile Packard Children’s Hospital earned the Child Health Corporation of America's (CHCA) 2007 RACE for Results award for its success in implementing Rapid Response Teams.

  • 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

  • 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 (PDF). 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 IHI Prevention of Central Line-Associated Bloodstream Infection campaign (PDF). You can also learn more about our CABSI infection rates.





Lucile Packard Children's Hospital is located in Palo Alto, adjacent to Stanford University Hospital, approximately 20 miles north of San Jose, CA and 40 miles south of San Francisco.


Lucile Packard Children's Hospital
725 Welch Road
Palo Alto, California 94304
(650) 497-8000


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