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Original Research

Open Access Special Issue

Improving the mortality index among gynecologic oncology patients

  • Jolyn Taylor1,*,
  • Jennifer Miller2
  • Edith Ballard3
  • Corrine Byrd2
  • Anita Holloway4
  • Arletta Smith3
  • Anne K. Park5
  • Larissa A. Meyer1
  • Karen H. Lu1
  • Kathleen M. Schmeler1

1Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA

2Health Information Management, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA

3Revenue Operations and Coding, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA

4Institutional Compliance, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA

5Office of Performance Improvement, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA

DOI: 10.22514/ejgo.2022.015 Vol.43,Issue 3,June 2022 pp.111-117

Submitted: 24 February 2022 Accepted: 19 April 2022

Published: 15 June 2022

(This article belongs to the Special Issue Gynaecological Oncology: Challenges for the 21st Century)

*Corresponding Author(s): Jolyn Taylor E-mail:


Background: The mortality index is a quality metric that measures the ratio of observed mortality to expected mortality among inpatients. Expected mortality is a probability calculation based on documentation of patient risks and comorbidities. A mortality index of <1.0 represents fewer patients dying while admitted to the hospital than expected. We aimed to decrease the mortality index in our department by 10% in 6 months. Methods: We formed a multidisciplinary team from Gynecologic Oncology, Health Information Management, Office of Performance Improvement, Revenue Operations, Coding and Institutional Compliance. We educated providers on documentation of patient comorbidities, standardized documentation templates, focused coder analysis and in-depth review and discussion as a department of all inpatient deaths. Pre-intervention 8/2017–7/2018 and post-intervention 11/2018–2/2020 outcomes were compared using the Mann Whitney U test. Results: The median mortality index decreased by 44% from 0.84 to 0.47 (p = 0.03). The median expected mortality increased by 37% from 2.94 to 4.02 (p = 0.002). The median number of inpatient deaths, or observed mortalities, was unchanged though there was a non-significant decreasing trend. Conclusions: Inpatient mortality index is an important quality metric that can be improved through education, standardized documentation, focused review and discussion of all inpatient mortalities.


Mortality index; Mortality review; Inpatient mortality

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Jolyn Taylor,Jennifer Miller,Edith Ballard,Corrine Byrd,Anita Holloway,Arletta Smith,Anne K. Park,Larissa A. Meyer,Karen H. Lu,Kathleen M. Schmeler. Improving the mortality index among gynecologic oncology patients. European Journal of Gynaecological Oncology. 2022. 43(3);111-117.


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