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About Us - Our Performance - Hospital Standardized Mortality Ratio (HSMR) - Overview


The Ministry of Health and Long Term Care requires that all eligible hospitals publicly report their Hospital Standardized Mortality Ratio(HSMR). This is one of eight patient safety indicators that are included in the Ministry's mandatory reporting initiative.


What is HSMR and what does it measure?

HSMR is one of a number of important quality and safety measures designed to improve patient care. It is a new measure of patient safety which tracks hospital mortality (death) rates in order to reduce avoidable deaths in hospitals and improve quality of care. HSMR compares an individual hospital's mortality rate with the average Canadian rate. It examines observed versus expected deaths and is adjusted for various factors including age, sex, diagnoses and admission status of patients.


Why is HSMR important?

HSMR was developed in the United Kingdom in the mid 1990's, and is used in hospitals worldwide to assess in-hospital mortality rates and to help organizations identify areas for improvement. HSMR is a quality indicator and a measure to help hospitals and health professionals follow trends in their hospital mortality rates. It is yet another tool to help improve quality of care and patient safety over time.


How will HSMR be used in hospitals?

Ontario hospitals are beginning to use HSMR results for internal benchmarking purposes. The reporting of HSMR shows hospitals how their ratio has changed, where they have made progress and where they can continue to improve. Through HSMR, hospitals will learn more about the tool, more effectively examine their results, identify areas for improvement, implement strategies to lower mortality and track results over time.


How is HSMR calculated?

The Canadian Institue for Health Information (CIHI) has calculated the HSMR for eligible acute care hospitals and regions in Canada (excluding Quebec). The HSMR is the ratio of the actual number of deaths, compared to the expected number of deaths, times 100.


Number of (actual) observed deaths x 100

Number of expected deaths


How are HSMR scores interpreted?

  • A ratio that is equal to 100 suggests that there is no difference between the hospital's mortality rate and the average national rate.
  • A ratio greater than 100 suggests that the hospital's mortality rate is higher than the average national rate.
  • A ratio less than 100 suggests that the hospital's mortality rate is lower than the average national rate.

How often will HSMR results be reported?

The mandatory public reporting requirement for the Ministry of Health and Long Term Care is that hospitals post their HSMR results annually.


More patient-specific information is available at and,


If you have any questions about our hospital’s infection prevention and control program, please contact Mackenzie Health Infection Prevention and Control Department at

Mackenzie Health / 10 Trench St. Richmond Hill, On. L4C 4Z3 / Richmond Hill Line: 905-883-1212 or Vaughan Line: 905-832-4554 / TTY Service: 905-883-2123