PT  - JOURNAL ARTICLE
AU  - Sega Pathmanathan
AU  - Rebecca Dickinson
AU  - Simon Hart
AU  - Jaymin Morjaria
TI  - Using mortality reviews to shape future service planning
DP  - 2013 Sep 01
TA  - European Respiratory Journal
PG  - P1043
VI  - 42
IP  - Suppl 57
4099  - http://erj.ersjournals.com/content/42/Suppl_57/P1043.short
4100  - http://erj.ersjournals.com/content/42/Suppl_57/P1043.full
SO  - Eur Respir J2013 Sep 01; 42
AB  - Introduction:Clinical governance is an important part of service evaluation and future planning. To facilitate reflection and learning from inpatient care, we commenced a monthly meeting to discuss all deaths occurring on the respiratory unit.Methods:All deaths, between November 2010 to 2012 in the unit (60 inpatient including 6 high dependency beds), were reviewed in a monthly departmental meeting. In addition to cause of death, co-morbidities were collated for each patient.Results:There were 4560 admissions in the unit with 325 deaths (7.1% of all admissions). 123 deaths were related to COPD, 86 related to pneumonia, 61 to cancer and cardiac conditions contributed to 90 deaths. 253 cases (of which 210 were primarily respiratory) were reviewed and data included in the analysis. The most common cause of death (1a on death certificate) was pneumonia (76 deaths; 23.3% of all deaths). Of the respiratory deaths, COPD contributed 50 (19.8%), lung cancer 29 (11.5%) and fifty-five (22%) were caused by other primary respiratory conditions (e.g., pulmonary fibrosis, pulmonary embolism). Of note, cardiac conditions were the most frequent co-morbidity in respiratory deaths (74).Conclusion:Inpatient mortality meetings allow the members of the respiratory department to discuss challenging cases and learn from their outcomes with the aim of improving service provision. In total, smoking-related lung diseases contributed to 161 deaths (64%). The Hull and East Riding area has a higher smoking rate than the average in the UK (32% vs 22%). To combat this we have introduced an on-site smoking cessation service in the chest clinic and on all hospital wards with the aim of improving patient education, overall health, and reducing mortality.