Good leaders dont waste money. Right treatment is never waste. Unnecessary investigation, uncessesary CPR and medication all waste of money. I am not jocking Sir and I am happy to share where we waste money and how we reduced harm to patients by 90%
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May I ask a couple of question on the weekly death reports please? (Are you still doing them btw?) You exclude from investigation: > Pts admitted to die > Pts admitted to ITU > Pts put on the dying pathway Why this last group? How many are excluded because of that factor alone?
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In theory death review is good only if it is done properly and with
#Candour and full engagement of families. -
Absolutely. I appreciate that. My question is more to do which cases you include for review - and specifically why you choose to exclude those placed on the death pathway.
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1 Unexpected death 2 Family unhappy or has concerns 3 Death which should be referred to
#Coroner and any one has any concerns This is my personal view@martinfarrier is an expert -
Ok, thanks Umesh. Wonder if
@martinfarrier will have any thoughts on this question? The point was discussed at CQC's board meeting just 10m15s into the video >https://m.youtube.com/watch?v=fxh95M_85PM … -
Unexpected death should = a death where anticipatory care is not given. That’s really the deaths we review.
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Appreciated. My concern was the inclusion of those put on the death pathway as a separate category. If they were not admitted to die & not admitted to ICU, I just thought any such pt then put on the death pathway would be reason to investigate death, not exclude. Is it just me..?
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We did multiple months of “death pathway” reviews and found fewer errors. These deaths turned out to be the low risk deaths.
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