Hospital Standardized Mortality Ratio


The hospital standardized mortality ratio (HSMR) is a patient safety measure that compares a hospital’s number of deaths to the average national rate. The ratio provides a starting point to assess mortality rates and identify areas for improvement, which may help to reduce unexpected hospital deaths.

The Canadian Institute for Health Information (CIHI) calculates the normal number based on averages from hospitals across Canada. When tracked over time, the HSMR indicates how successful hospitals or health regions have been in reducing inpatient deaths and improving care.

The HSMR is a ratio of observed deaths to the expected number of deaths of patients in acute care hospitals, multiplied by 100. The HSMR is adjusted for other factors affecting mortality, such as age, sex and length of stay. 

A ratio of 100 indicates there is no difference from the national rate. A ratio greater than 100 means more deaths occurred than expected. A ratio less than 100 suggests the hospital’s mortality rare is below average.


North York General Hospital regularly monitors and reviews performance indicators such as the HSMR and uses this information to execute best practice protective measures and continually improve patient care and safety.

See NYGH’s HSMR results on the Canadian Institute for Health Information’s (CIHI) Your Health System website. Learn more about HSMR on the CIHI website. 

What we are doing to improve patient safety 

North York General has undertaken many initiatives to provide patients with safer care including:

  • Adopting and executing the six interventions set out by the Safer Health Care Now campaign aimed at reducing the number of injuries and deaths related to adverse events, such as infections and medication incidents. 
  • Actively implementing an aggressive hand washing campaign across the entire hospital to dramatically increase hand washing compliance rates
  • Developing a comprehensive system for screening and surveillance of high-risk patients for infectious syndromes (e.g. diarrhea, meningitis, etc.) and antibiotic-resistant organisms (methicillin-resistant staphylococcus aureus or MRSA, vancomycin-resistant enterococci or VRE, C. difficile, etc.).