Public Reporting Of Outcomes

“Virginia Mason Memorial is the first Hospital in the Country to require Physician assessment of life span and prognosis for every Hospitalized patient at the time of admission.  Virginia Mason Memorial leads the way for this National Benchmark from the Circle of Life Symposium in October of 2015”.

Laurie Jackson, Senior Director Compass Care

Virginia Mason Review of The Surprise Question at Admission in 2017

  • Beginning in Jan 2017 all physicians must answer the Surprise Questions when completing admission orders for a hospitalized patient. The question is:  “Would you be surprised if this patients died within the next 6 months?”
  • Any answer of “NO”, generates an automatic referral to the inpatient navigation team for a Palliative Care visit to the patient.
  • 5,522 Surprise Questions were asked and answered in Q 1 of 2017. Accuracy of data has up to a 6 month time lag awaiting state death records to check for accuracy of Physician responses at admission.

Findings:

Based on State death data thru 6/30/17:

2016 Mortality Post-Admit.  N = 5,522 Surprise Questions

Days From Surprise Question Answer

Percentage of Patients who Died in this time period

Days 1 thru 30

61.63% of deaths

By Day 60

74.55% of deaths

By Day 90

81.86% of deaths

By Day 120

88.03% of deaths

Follow-up Plan:

  1. Continue with comprehensive use of the Surprise Question for every hospital admission.
  2. Continue tracking and reporting on the accuracy of results over time as monthly State death data is reported to VMM.
  3. Socialize and expand the use of the Surprise Question throughout the VMM system into outpatient settings and clinics. Considering implementation at North Star Lodge in early 2019.
  4. Provide care consistent with the goals and values of each patient – providing truly patient-centered care as end-of-life approaches.
  5. Reduce futile or non-beneficial care at End-of-Life.

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