​A study published in the March issue of Surgery found that many failure-to-rescue (FTR) events—deaths that occur after a complication—are not preventable, calling into question whether failure to rescue, as defined, is appropriate to use as a metric for quality of care. The authors performed a search of the University of Pennsylvania's trauma registry for inpatients who presented to its level I trauma center between 2005 and 2015. Of the 26,036 patients in the cohort, 2,735 (10.5%) experienced complications, and 360 of those patients later died, resulting in an FTR rate of 13.2%. A peer review panel examined the 360 FTR deaths and judged 272 (75.6%) of them to be nonpreventable, 65 (18.1%) to be potentially preventable, and 22 (6.1%) to be preventable. According to the authors, the term "failure to rescue" implies that rescue is possible; however, the low percentage of FTR events that were deemed preventable suggests "that a better understanding of what is truly a failure of medical care is needed for FTR to be considered an accurate measure of hospital quality in the trauma population."

HRC Recommends: Measuring the quality of care and making the information available to stakeholders in the healthcare system is essential to improve care and enhance patient safety. Measuring hospital performance related to the quality of care verifies that evidence-based treatments—treatments demonstrated by scientific evidence to lead to better outcomes—are consistently provided. However, a hospital's process performance alone does not convey information about hospital quality that extends beyond what is actually being measured. As the soundness of certain clinical treatments changes and evolving evidence provides increased knowledge, measures identified to monitor hospital performance must change as well.