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Two Years of Mortality Progress: For Every Patient Drives Meaningful Change

3 minute read
A female doctor stands and uses a stethoscope to check on a Black female patient

Two years ago, Mass General Brigham had multiple approaches to quality, safety and equity across our system. Now, one integrated team works in unison toward a singular strategy and goal, achieved through shared tactics and measurements.

New data affirms why this is so important: As we mark two years since the launch of our single systemwide approach to quality, we have seen a dramatic reduction in observed-to-expected mortality at our academic medical centers (AMCs).

A recent analysis of expected versus observed deaths at our academic medical centers shows an ever-widening gap between the two metrics, amounting to more than 1,400 lives since January 2023, when we first began to organize a single quality structure and drive a sustained, systemwide focus around a common goal, strategy, and tactics for quality.

Observed-to-expected mortality is one of many standardized ways hospitals assess care quality. It compares the number of patients who die while hospitalized against how many were likely to die based on factors like their age and severity of illness. 

Over the past two years, we have seen far fewer inpatient deaths than expected at our AMCs. While many factors contribute to this metric, the biggest driver by far is improving the quality of care our teams deliver. By providing timely care, improving infection control, preventing injury and many other practices, we ensure patients do not suffer or die due to preventable causes.

Beginning in 2023, our quality teams integrated under the Office of the Chief Medical Officer. This marked a new era of unified measurement and analytics, a unified goal of improving in-hospital mortality, unified tactics like our Early Warning System and better clinical documentation — all guided by unified quality strategy, For Every Patient, which drives this work.

This progress is only possible because our teams are working together, rallying around a common goal and executing a common strategy, explained Tom Sequist, MD, MPH, chief medical officer for Mass General Brigham.

“With all teams across hospitals working together toward the same goal, we can make much more meaningful progress than when everyone is working independently, with different priorities, goals, strategies and measurement​,” Sequist said. “Our mortality data illustrates what is possible when we take this approach.”

Rachel Sisodia, MD, chief quality officer for Mass General Brigham, applauded the efforts of clinical teams for their commitment to this work.

“By maintaining this laser focus on quality, you are not just improving numbers — you are giving more families precious time with their loved ones, and that’s the heart of why we all do this work,” she said.