PrintIn an effort to improve care and reduce patient deaths, UHN along with other Canadian healthcare organizations, will track mortality in comparison to the overall average rate. The Canadian Institute for Health Information (CIHI) has initiated the publication of the Hospital Standardized Mortality Ratio (HSMR) for all Canadian healthcare organizations, which will allow UHN and other facilities to follow their HSMR and track their successes.
Similar campaigns in the United Kingdom and the United States have helped identify areas for performance improvement including prevention of surgical infection, ventilator-associated pneumonia, and central line-associated bloodstream infection Other areas of improvement include best practice treatment for heart patients and prevention of falls and pressure ulcers.
The standardized mortality ratio will be calculated on a quarterly and annual basis and the change in UHN's score will be tracked over time. Observing mortality rates will help assess the effectiveness of performance improvement strategies, which will ultimately strengthen the quality of care provided at UHN.
How is the Hospital Standardized Mortality Ratio (HSMR) measured?
The HSMR is the ratio of actual number of deaths to the expected number of deaths among hospitalized patients. The number of expected deaths is based on the average experience of all Teaching Hospitals. The HSMR is based on patient groups that account for 80% of deaths in acute care hospitals. In addition, the HSMR takes into account factors that affect mortality such as age, sex, and length of stay.
An HSMR equal to 100 suggests that there is no difference between the hospital’s mortality rate and the overall average rate; greater than 100 suggests that the mortality rate is higher than the overall average; and less than 100 suggests that the mortality rate is lower than the overall average.
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Tracking UHN’s Progress
In fiscal year 2006-2007, UHN recorded an overall HSMR of 84, which was lower than the expected mortality rate for the type of patients treated at UHN and lower than the previous two years. This indicates that overall mortality ratios at UHN have improved.
UHN has the goal of improving patient-centred care by implementing best practices and ensuring patient safety. For example, UHN has the objective to eliminate hospital–acquired infections and pressure ulcers as well as prevent severe medication errors. UHN is actively participating in Safer Healthcare Now initiatives including establishment of the Critical Care Response Team, which quickly identifies and facilitates the resuscitation of inpatients. These and other patient safety initiatives will ensure continued commitment to reducing patient mortality.
