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Quality Measurement Framework

Hospital Standardised Mortality Ratios (HSMR)

NHS National Services Scotland ISD Scotland & NHS National Services Scotland

Hospital Standardised Mortality Ratios (HSMR)

This measure is the key outcome indicator from the Scottish Patient Safety Programme, and safety is a priority ambition for the Quality Strategy. A national reduction in HSMR should reflect work in individual hospitals to review mortality, and reflect reduction in serious adverse events and infections under the Scottish Patient Safety Programme and other improvement initiatives.

The HSMR is a measurement tool where mortality data are adjusted to take account of some of the factors known to affect the underlying risk of death. The HSMR is calculated as the ratio of the actual number of deaths within 30 days of admission to hospital (irrespective of place of death) to the expected number of deaths. (The probabilities of death used in the calculation are based upon national data using the updated base period January 2011 to December 2013).

Indicator Update

The model was re-based in 2016, ensuring that the predicted mortality used within the HSMR calculation is based on up to date data. This release uses the updated base period and is not comparable to previous releases. For more information see HSMR Guidance and FAQs page.

The latest figures, published in August 2017, show that the HSMR at Scotland-level has decreased by 8.4% between the baseline period (January 2011 to December 2013) and the latest quarter January to March 2017, using regression line values. The Scottish HSMR for January to March 2017 is currently 0.93.

Source: latest results published August 2017 by ISD

Work that should result in improvement in this indicator

Data on hospital mortality have an important role to play in stimulating reflection on the quality of patient care. The HSMR for each Scottish hospital is published quarterly, and a considerable amount of activity is being carried out in individual hospitals nationwide to use this tool to reflect on clinical practice and facilitate improvements in patient care.

In addition to this, safety initiatives in hospitals to reduce infections and other adverse events, being more proactive in managing at risk patients and technological advances should all play their part in reducing this indicator.

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