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Can data monitoring save patients?

20th March 2009

The Economist praises the Healthcare Commission's "early warning" system.

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Stafford Hospital has emerged as a "disastrously managed institution" where at least 400 more patients died than expected in a three-year period.

Such findings triggered apologies from Health Secretary Alan Johnson and Prime Minister Gordon Brown, amid accusations - which the two politicians subsequently denied – that the Stafford situation was made worse by pressure to meet targets.

The Healthcare Commission, which noticed failings at the hospital in 2007, seems to support the target pressure view in its report.

But its investigation began because it was monitoring routine data on hospital admissions, treatment and outcomes.

Cambridge University statistician David Spiegelhalter says the commission’s early-warning system grew out of the Bristol Royal Infirmary inquiry after high death rates after heart surgery on children and another into Harold Shipman to determine whether the GP’s killing spree could have been detected sooner.

In both instances, if such monitoring had been in place, the patterns might have been picked up before more patients died.

The Commission discovered, from taking key factors into account, Stafford Hospital had a consistently high death rate for patients admitted as emergencies.

The findings were not caused by chance or error, leading the commission to seek an explanation from the hospital. Unable to give one, a full-blown investigation was launched with the findings published in mid-March.

Such monitoring has shown that target setting can lead to perverse results but it is also a "shining example of how health-care data can be used to spot problems fast."

 

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