Performance data and the mortuary register.

Abstract

OBJECTIVE: To compare departmental records of deaths after cardiac surgery with the hospital's information system. DESIGN: Matched pairs comparisons: (i) historic record compared with current record from another source; (ii) contemporary records from different sources; and (iii) timed records from different sources. SETTING: Regional cardiothoracic units at St George's and St. Thomas's Hospitals. SUBJECTS: 2664 cardiac surgical operations at St George's between January 1992 and June 1994, 215 deaths in the cardiac surgery database at St Thomas's between April 1993 and March 1997, 120 in-hospital deaths received by the mortuary at St George's during June 1999. MAIN OUTCOME MEASURES: The difference in the number of in-hospital deaths from departmental, hospital, and mortuary sources. RESULTS: Four of 2664 operations (0.15%) had been incorrectly coded as leaving hospital alive. Fewer than 80% of the actual number of deaths after cardiac surgery at St Thomas's had been recorded on either the departmental database or the hospital administration system. For 9% of deaths received in the mortuary, it took more than 6 working days for the hospital record to be updated, and at the time of reporting 1 case had not been updated after 14 working days: the date of death was inaccurate in 4/113 (3.5%) of cases. CONCLUSIONS: The mortuary staff can contribute to improving the accuracy of body counts. Death rates and performance data should not be published without statistical peer review.