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This paper discusses the Hospital Standardized Mortality Rate (HSMR) as developed by Sir Brian Jarman at Imperial College, London. It analyzes mortality rates in Dutch hospitals from 2001 to 2003 while considering factors such as age, severity of diagnosis, and patient demographics. The goal is to improve patient safety and reduce unnecessary deaths through new measures and real-time monitoring. By identifying bottlenecks and leveraging a comprehensive analysis of nursing and medical information, hospitals can enhance care quality, ultimately fostering better outcomes for patients.

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  1. Move your Dot Ir. Laurens Touwen Board of directors

  2. 180 160 140 120 100 80 Standardised death rate 60 40 20 0 0 5,000 10,000 15,000 20,000 25,000 Standardised charge $ per admission Hospital age, sex, race, payer, admission source, admission type standardised death rate vs age, diagnosis standardised charge per admission, AHRQ 1997 data

  3. Yearly paper of Dr Foster with all hospitals and there HSMR

  4. Originator of HSMR is sir prof. Brian Jarman Imperial College, London

  5. Number of deaths per year, related towards age, severeness etc. in comparison with expected death Is there a number of persons that too early died? Purpose: - to improve quality in terms of safety and effectiveness of care- avoid unnecessary deaths Development new measure:Hospital Standardized Mortality Rate HSMR

  6. Dutch HSMRs vs year (using year 2003 as the standard)

  7. Dutch hospital standardised mortality ratios 2001-3(HSMRs) vs hospital(standardised for age, sex, urgency/readmission, LOS within 50 CCS groups leading to 80% all deaths,excluding small hospitals and those with poor data recording, using year 2000 standard) 112 Where are we now? Be careful: not the dot, but the interval 72

  8. AEX – composite of many share-values HSMR – composite of many diagnoses Which one is influencing the result especially? Realize: HSMR is a mean, always there is one below and one above!! As a country you strive to squeeze the spread to a minimum. HSMR as an AEX

  9. Analysis of medical and nursing information/status:you learn a lot about your own organization Help of triggertool Where are the bottlenecks? Analysis of HSMR based on individual diagnoses Look for interventions for specific groups Introduce Real Time Monitoring Move Your Dot =to lower the HSMR

  10. Validation piramide Part of Real Time Monitoting

  11. Walsall CUSUM HSMR Real-Time Monitoring - 172,000 admissions over 10 years Mortality reduction measures Started January 2001 Recent financial problems

  12. Call SIT (Rapid Response Team)in due time

  13. Scorecard for every nurse

  14. Improvement of patientcare, Better care for the living!! What is our motive

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