Dr Foster's Case Notes

Monitoring changes in hospital standardised mortality ratios

BMJ 2005; 330 doi: http://dx.doi.org/10.1136/bmj.330.7487.329 (Published 10 February 2005) Cite this as: BMJ 2005;330:329
  1. Brian Jarman,
  2. Alex Bottle,
  3. Paul Aylin,
  4. Mike Browne
  1. Dr Foster Unit, Imperial College
  2. Walsall Hospitals NHS Trust

    Routinely collected hospital episode statistics data can be used to calculate hospital standardised mortality ratios and adjusted death rates for various diagnoses and procedures.w1 Providing this information to hospitals can prove a stimulus to the introduction of a range of improvements in hospital care, mainly with the aim of reducing avoidable deaths. The subsequent changes in mortality can be monitored. We report the experience of Walsall Hospitals NHS Trust.

    The bottom line

    • In 2000 Walsall Hospitals NHS Trust had an HSMR of 130, the highest of all main acute hospitals in England

    • After the HSMR data were published Walsall set up seven clinical governance groups to identify where improvements could be implemented

    • The hospital's mortality data were monitored over the next four years, and by September 2004 the HSMR had dropped to 92.8

    Hospital medical care has become more complex than it was in the days when there were few effective treatments available. Now …

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