Hospitals judged to have excessive patient death rates for specific conditions will be identified so that corrective action can be taken on any safety issues, under a new system to be introduced shortly by the HSE.

The health executive says it expects that comparative hospital mortality information will be made publicly available for the first time once the new Irish Hospital Mortality Index (IHMI) is up and running.

The HSE told irishhealth.com that under the new system, patient outcomes will be assessed based on the condition they were treated for, and the expected number of deaths for each hospital for each condition according to set norms will be compared to the actual number of deaths recorded.

Using this system, the HSE will be able to identify 'outlier' hospitals which might be recording mortality rates above the expected norms for particular conditions.

A HSE spokesperson said the specific purpose of comparative hospital mortality patterns is to enable hospitals to use the data generated to prioritise areas for review and potential improvements so that the best outcomes are achieved.

The HSE said it is intended that this data will be made publicly available once the system has been fully developed and its accuracy assured, allowing a period of time for the HSE to work with hospitals to ensure accuracy of data generated.

The health executive stressed that in order to arrive at accurate comparative mortality rates between institutions, confounding factors that might explain variations in death rates would first be taken into account.

These would include age of patients, medical card status, patient numbers, and whether patients had other conditions along with the condition being treated.

Meanwhile, a separate national audit of mortality following surgical procedures is expected to get underway by the end of this year, following delays due to concerns over  confidentiality and data protection issues.

The Irish Audit of Surgical Mortality will involve surgeons reviewing the outcomes of procedures by their peers.

However, there were concerns that individual surgeons and their performance could be identified publicly under the system through Freedom of Information or document discovery in legal cases or that surgeons reviewing their colleagues' work could be identified.

These difficulties are currently being looked into by the HSE.

Consultant surgeon Mr Ken Mealy, who is heading up the audit process, said it was hoped that information could begin to be collected under the audit by the end of the year.

He said that with the surgery audit, the public interest had to be balanced against the need to have 'buy in' by surgeons into the process.

Mr Mealy said 95% of surgeons said they would be happy to engage with the audit of their performance provided the confidentiality issues were addressed.

It is not planned at this stage to make any data on hospitals' surgery performance publicly available under the surgery audit. The audit will, however, be able to identify poor performance among of individual surgeons or units so that remedial or regulatory action can be taken where necessary.

The surgery audit is being run by the National Office of Clinical Audit at the Royal College of Surgeons in Ireland, in cooperation with the HSE.