Hospital Standardized Mortality Ratio (HSMR)
The Hospital Standardized Mortality Ratio (HSMR) is an important “big dot” measure of quality and patient safety in a hospital. HSMR is a ratio of the actual number of deaths compared to the expected number of deaths, based on a sum of probabilities. This ratio provides hospitals with a starting point to identify improvements that will reduce the number of deaths.
Articles
Joseph Brant Hospital Supports Performance Reporting and Funding Decisions with SAS® 
This article describes how SAS was used by Joseph Brant Hospital to report on its HSMR. 
The RN workforce and hospital mortality
UBC Nursing News, July 8, 2011. A look at Sandra Regan’s doctoral research, which examines the relationship between registered nurses and hospital mortality.
FAQs
Hospital Standardized Mortality Ratio (HSMR)
Ontario Hospital Association (OHA), 2009. This page also provides members with access to HSMR communication packages.
Guidelines
Reducing avoidable mortality: Medical Directors drive improvement 
NHS Institute for Innovation and Improvement, 2007. This guideline lays out five key ways that medical directors can help reduce avoidable mortalities in their institutions.
Reducing avoidable mortality: Chief Executives lead the way
NHS Institute for Innovation and Improvement, 2007. This guideline lays out five key ways that chief executives can help reduce avoidable mortalities in their institutions.
White papers
Move Your Dot™: Measuring, Evaluating, and Reducing Hospital Mortality Rates (Part 1)
Institute for Healthcare Improvement (IHI), 2003. Move Your Dot™ is an initiative that helps hospitals measure their performance vis-à-vis mortality, and to compare their rates to other hospitals’.
Reducing Hospital Mortality Rates (Part 2)
Institute for Healthcare Improvement (IHI), 2005. Move Your Dot™ is an initiative that helps hospitals measure their performance vis-à-vis mortality, and to compare their rates to other hospitals’. This white paper updates the work detailed in Move Your Dot™: Measuring, Evaluating, and Reducing Hospital Mortality Rates (Part 1).
Tools and Resources Related to Move Your Dot™: Understanding Your Hospital’s Mortality Rate
Institute for Healthcare Improvement (IHI). Move Your Dot™ is an initiative that helps hospitals measure their performance vis-à-vis mortality, and to compare their rates to other hospitals’.
