Higher than expected cardiac surgery mortality rate

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Reference no: EM132282790

Quality Concepts in Action Scenario

The board of trustees receives information/data that the hospital has a higher-than-expected cardiac surgery mortality rate and has been ranked near the bottom of comparable hospitals in the region. A board member asks the medical director for an explanation, and the director in turns ask the appropriate surgeons. The surgeons say that their patient population is complicated, their patients have many co-morbid conditions, and no other institution is willing to operate on such high-risk patients. Since some of these surgeries are successful, shouldn't they take action on prolonging the lives of these patients? This emotional plea is impossible for board members to answer since it is not their role to determine medical suitability for surgery. Although this ethical dilemma is difficult to resolve, the board wants to resolve the difference between what the surgeons say and what the data show.

Consider the pros and cons of the following actions:

Since the surgeons are highly respected and well qualified and bring in many patients and therefore much revenue to the hospital, the board agrees to ignore the data and leave things alone.

The board asks quality management to find a way to frame the data so that the community is reassured that the hospital is delivering good care.

Quality management analyzes the mortality data and tries to ascertain the difference between those patients who have successful outcomes and those who do not, hoping to target improvements and develop processes for better outcomes.

The board and senior leaders decide to fire the surgeon with the worst outcome under the assumption that the rankings will then improve.

The board and senior leaders determine that hiring a consultant to review the data and make changes in the department will lead to improvement

If you were the director of quality management, which of these options would you recommend and why?

Reference no: EM132282790

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