SMH actual death rate after major surgeries not reflected in
CIHI study
Posted March 12,
2013
A report by the Canadian Institute for Health Information that listed
Stevenson Memorial Hospital (SMH) with an unadjusted upper limit case
(ULC) rate of 164
in-hospital deaths, per 1,000 patients within five days of
major surgery in 2011-12, should in fact have shown it at zero when all
the factors related to the small sample size are included.
"Last year, we completed 4,100 OR cases, 300 were inpatient cases
and 3,800 were day surgery cases," according to Kathy Stevenson, SMH,
Manager Quality, Patient Safety and Risk Diagnostic Services. "Of the
300 inpatient cases, only 17 met the inclusion criteria for Major
Surgeries. There were 0 deaths for any major surgeries."
A further explanation from the Canadian Hospital Reporting Project Team
which prepared the annual report posted last Wednesday, noted the SMH
"adjusted facility rate is 0.00 per 1,000 cases, with a lower
confidence limit (LCL) of 0.00 and an upper confidence limit (UCL) of
164.10. This means that we can say with 95 per cent accuracy that
your facility adjusted rate can be anywhere between 0.00 and
164.10. This rate is not significantly different compared to the
Canada average (8.62) since the Canada average falls between the LCL
and the UCL (0.00 to 164.10) of your facility adjusted rate.
Below are other highlights from the study as they relate to SMH:
C-sections: 32.7 per 100
VBAC: 20 per 100
Coronary Angio following AMI: 57 per 100
28 day readmission - AMI: 20 per 100
28 day readmission - Stroke: 11 per 100
30 day mortality - AMI: 17 per 100
30 day mortality - Stroke: 4 per 100
30 day readmission - Medical: 12 per 100
30 day readmission - Obstetrics: 1 per 100
30 day readmission - Overall: 8 per 100
30 day readmission - Surgical: 5 per 100
30 day readmission - 19 and under: 3 per 100
SMH spends eight per cent of its operating budget on administration
including finance and human resources. And SMH's cost per weighted case
is $4,995.
