Hospital mortality indicators (i.e. indicators about trends of death) are crucial elements of a hospital patient safety monitoring program. Some hospital mortality indicators, such as hospital-standardised mortality ratios (HSMRs), allow a comparison between the number of deaths that occurred in a hospital and the number of deaths that could have been expected, taking into account hospital and patient characteristics. Hospital mortality indicators are best used as safety and quality screening tools to support clinical governance by flagging potential areas of concern or best practice, not as measures of performance.
In 2009, Australian Health Ministers agreed to ensure each state and territory’s hospital mortality data was gathered and presented to their respective hospitals for regular review, along with infection rates, readmission rates and patient experience survey results.
The hospital mortality indicators endorsed by Health Ministers are:
- Hospital-standardised mortality ratios
- Death in low mortality diagnosis related groups
- In-hospital mortality for four specified conditions.
These indicators are included within the core hospital-based outcome indicators.
A guide for Boards and Chief Executives on Hospital Mortality Indicators
To support local interpretation and use of hospital mortality indicators, the Commission developed Using Hospital Mortality Indicators to Improve patient Care: A guide for Boards and Chief Executives (the Guide). The Guide has been prepared for Boards and Chief Executives of hospitals and Local Hospital Networks (LHNs). It provides information on how hospital mortality indicators can be used to screen for potential safety and quality issues through existing clinical governance processes.
Hospital Mortality Indicator Literature Review
Melbourne Health carried out a literature review for the Commission. The Hospital Mortality Literature Review examines the usefulness and limitations of hospital mortality indicators. It is comprised of three parts, the body of the literature review, international case studies (Canada, United Kingdom, United States) and relevant appendices. The review focused on literature from 2010–13.