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PSNet: Patient Safety Network
Journal Article
Review

Ranking hospitals based on preventable hospital death rates: a systematic review with implications for both direct measurement and indirect measurement through standardized mortality rates.

Manaseki-Holland S, Lilford RJ, Te AP, et al. The Milbank quarterly. 2019;97:228-284.

Measuring patient safety remains an ongoing challenge. This systematic review examined whether preventable death rates could be used as a measure of hospital quality. Researchers reviewed 23 studies and found that estimates of preventable in-hospital death are consistently low. Ascertainment of preventability was not consistent across multiple clinician-reviewers, and the authors estimate that cases would need review by eight or more clinicians to achieve the precision required. The authors conclude that preventable death rates would not be a valid or reliable measure of patient safety. A past PSNet interview discussed the development of hospital standardized mortality ratios and their role in monitoring performance.