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opinion

Nurse Sedi Aboutalebi uses a scanner to read a barcode imbedded on patient Ken Seetaram's wristband at Toronto's St. Michael's Hospital April 11, 2011.Moe Doiron/The Globe and Mail

Finally, some good news: Fewer Canadians are dying after being admitted to hospital.

Until the Canadian Institute for Health Information began tracking this seven years ago, the death rates of hospitals were largely unknown.

Since then, 53 per cent have experienced a significant drop in their hospital standardized mortality ratios; for 44 per cent, the ratio has remained about the same, and for 3 per cent, it has significantly increased.

It's better to have a number at or lower than 100, a ratio that represents the actual number of in-hospital deaths in a hospital or region, compared with the number of people who would have been expected to die based on the national average and types of patients treated. A central Newfoundland regional health authority composed of nine hospitals had the highest ratio at 120, while Saint John Regional Hospital had the lowest at 62.

"The big advantage in my mind around that measure is that it's a wakeup call for hospitals that are truly not on the ball," said Ross Baker, a University of Toronto professor of health policy, management and evaluation. He was the lead author on a 2004 study that found about 185,000 of the 2.5 million annual hospital admissions in Canada are associated with an "adverse event," such as a complication resulting in a prolonged hospital stay, disability, unintended injury or death.

Reductions in hospital mortality are a success story, but far more work needs to be done. Care needs to be redesigned. Medical wards can be chaotic, disjointed and sometimes frightening places for patients. Better communication and standardized handoff protocols for staff would go a long way to make sure that patients' treatment needs are met. Standardized care could be applied to a number of procedures or operations, meaning that patients go through the same kinds of triage, care and the same rehabilitation. "Reliability is part of what we're talking about," said Prof. Baker.

The best hospitals in the world are focusing on redesigning care to enhance the patient experience by focusing on quality and safety, which helps brings down costs. Canadian hospitals should enact similar measures.

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