Dear Colleagues,

Hospital Standardized Mortality Ratio (HSMR) is a patient safety indicator on our UHN Balanced Scorecard and is calculated by comparing the number of deaths in our hospital to mortality rates in all other hospitals across the country. The average rate for all Canadian hospitals is represented by a score of 100. If the score is higher than 100, the risk of dying in that hospital is greater than average. If it is lower than 100, the risk in the hospital is lower than average.

HSMR is calculated on a national basis by the Canadian Institute of Health Information (CIHI) and it is always several months behind in reporting because CIHI needs to get all Canadian results prior to doing the calculations. We recently received our results for April 1 to September 30, 2008. These results are so good that I want to share them with you right away.

UHN has always been a performance leader in HSMR and we have been pleased to have results in the range of 85 to 90. With these previous scores we have usually been amongst the best performing hospitals in Ontario. But our results for the first half of 2008/09 are simply outstanding - in the mid 70s!! These are some of the best results that I have seen in any academic hospital. The results are particularly meaningful since we know that our units have been very stressed with overcrowding as we try to reduce waiting in our ER's and reach our budget targets.

HSMR tends to vary from month to month and we interpret these results with caution. We may see somewhat higher numbers in the next few months. However, we should certainly celebrate these remarkable results, especially since everyone in our hospital has been very focused on patient safety and I believe that we are seeing results from your efforts.

Think of all the safety initiatives that you have started at UHN over the past few years: MOEMAR, Surgical Checklist, safe medication practices, medication reconciliation, Safer Healthcare Now initiatives, Rapid Response Teams, Code Stemi, improved housekeeping and attention to a no blame safety culture (incident reporting, hand washing, Quality of Care investigations). Our Board Quality Committee has paralleled this attention to quality in reviewing our results and encouraging investment in safety.

Everyone at UHN has stepped up their practice in improving safety for our patients. These recent results suggest that what we are doing is working. Let's stay on course to make UHN the safest hospital in Canada!! Bob

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