Elevating patient care through improved mortality metrics

Author: Anna Rogers, Head of Client Partnerships at Telstra Health UK

The HSMR+ mortality metric signals a shift in how we measure and respond to patient mortality. These changes represent a leap forward, not only for healthcare providers but for the entire NHS.

In recent years, patient demographics have shifted significantly, and with that, so have the demands placed on our healthcare system. We are treating more elderly patients, managing more complex conditions, and witnessing how socio-economic factors deeply affect health outcomes across our NHS. The original model, while groundbreaking in its time, is no longer fully equipped to deal with these evolving challenges. This is why the introduction of HSMR+ comes at such a critical time.

HSMR+ offers a more comprehensive, data-driven approach to measuring patient outcomes, incorporating variables that reflect today’s evolving healthcare landscape.  It broadens our understanding of mortality beyond just age and comorbidities, bringing in new dimensions such as the Index of Multiple Deprivation and frailty.

One of the most significant advancements in HSMR+ is its recognition of health inequalities. With the inclusion of the Index of Multiple Deprivation (IMD), we can now account for the socio-economic factors that play a role in patient mortality. We know that people from more deprived areas often face higher health risks due to limited access to healthcare, poorer living conditions, and a myriad of other factors.

By incorporating these factors into the HSMR+ model, we’re no longer limited to assessing outcomes in a vacuum.  With the additional IMD analysis we will be able to pinpoint where deprivation is influencing outcomes, enabling customers to better tailor care to the needs of these vulnerable populations. In doing so, we’re supporting the work required to begin closing the health inequality gap and ensuring that patients receive equitable care, regardless of their socio-economic background.

The inclusion of the Dr Foster global frailty index in the HSMR+ model is another key improvement. As we treat an increasing number of elderly patients, we are all too aware that age alone is not a reliable predictor of mortality. Frailty, often characterised by multiple comorbidities and reduced resilience, significantly impacts patient outcomes but was previously underrepresented in mortality metrics.

With HSMR+, we can now account for frailty as a distinct factor, particularly in patients aged 75 and above. This means we can better capture the risks these patients face, leading to more accurate mortality assessments.

Now, with HSMR+, we have the flexibility to account for much higher levels of complexity. This is a huge step forward in making sure that the full scope of a patient’s health is represented in mortality metrics. When we see patients with multiple severe conditions, their risk can now be reflected in the data. This not only improves the accuracy of our assessments but also helps us to benchmark a hospital’s performance against others in a fairer, more nuanced way.

HSMR+ is more than just a tool for measuring mortality – it’s a framework for driving accountability and continuous improvement. By offering a more accurate representation of the factors influencing patient outcomes, HSMR+ enables us to take a deeper, more reflective look at our practices. Where are we excelling, and where can we do better? How do our outcomes compare with other hospitals that face similar patient populations?

HSMR+ allows us to engage in these critical conversations with data that reflects the true complexity of modern healthcare. It empowers us to make more informed decisions, whether that’s identifying areas for improvement in our care pathways or advocating for more resources to support our most vulnerable patients.

At Telstra Health, we’ve been showcasing HSMR+ at various conferences like the recent Patient Safety Congress in Manchester and the HPN Midlands conference, ready for our imminent launch. As we move forward, it’s clear that HSMR+ will play a vital role in shaping how we approach patient care. By recognising the multifaceted nature of patient mortality – whether it’s the impact of deprivation, the challenge of frailty, or the complexity of severe comorbidities – HSMR+ offers a more holistic view of our patients and their needs.

In the long run, the adoption of this updated model will lead to more targeted interventions, improved patient outcomes, and a stronger, more accountable healthcare system. For those of us dedicated to improving patient care, HSMR+ is a welcome and timely advancement. We are optimistic that it will not only enhance the way we measure mortality but also help us deliver the level of care that every patient deserves in the NHS.