An independent review of the National Audit of Hospital Mortality

The National Health Intelligence Unit (NHIU), Strategic Planning and Transformation in the Health Service Executive (HSE) developed the National Quality Assurance Improvement System (NQAIS) suite of tools in partnership with OpenApp, the National Clinical Programmes and other stakeholders. The NQAIS National Audit of Hospital Mortality (NAHM) web-based tool is one of those tools and helps participating hospitals to focus on their in-hospital mortality patterns. The NQAIS NAHM web-based tool analyses and displays mortality patterns across publicly funded acute hospitals. Since 2015, the National Office of Clinical Audit (NOCA) has worked to support the implementation and monitoring of NAHM in collaboration with the NHIU; since 2016, NOCA has produced a NAHM national reportthat is published annually. The NQAIS NAHM tool was the first tool in Ireland to allow hospitals to view hospital mortality data across all patient groups. While some enhancements were made to the tool in 2019, it is timely to review its progress with a broader remit, including public reporting. 

The NOCA Governance Board commissioned this independent review in order to explore whether the current NAHM is effective in terms of healthcare quality assurance and improvement. This review included an international consultation to compare approaches; a comprehensive approach to reviewing the literature, consisting of scoping and systematic components; and a local stakeholder consultation, including a survey of hospital data users, a separate survey of members of the general public, and two focus groups. Relevant stakeholders and the NAHM Governance Committee were then consulted to discuss the impact, feasibility and acceptability of a set of draft recommendations before arriving at the final versions of these recommendations.