Prof Palmer's investigation claims the Welsh Government cannot rely on the current risk-adjusted mortality index
(RAMI) measure to analyse if hospital deaths are signifi-cantly higher than expected.
The Risk-Adjusted Mortality Index
(RAMI) figures were published by Betsi Cadwaladr University Health Board for the period until the end of June 2013.
While the risk-adjusted mortality index
shouldn't be used in isolation to compare hospitals and LHBs, it is a key comparable indicator of what is happening in our NHS service.
The basic idea is to forecast the mortality index on paths and change the measure on each path to get the risk-adjusted mortality index
. We employ the Wang transform not only because it is easy to implement but also because the Wang transform can be easily extended in a multiple-period and multivariate-risk context.
Three Illinois organizations that understand the tangible clinical and financial return on investment from CPOE include: Decatur Memorial Hospital, Decatur, Ill., which improved the blood prescribing habits of its providers, reducing risk for patients, while reducing costs for the hospital; Dupont Hospital, Fort Wayne, Ind., which enhanced efficiency in its obstetrical unit by improving medication/order turnaround times, reducing STAT medication overrides, and freeing nurses to spend more time in direct patient care; and WellStar Health System, Marietta, Ga., which increased compliance with the national "Surviving Sepsis Campaign," and decreased the risk-adjusted mortality index
and cost per case.
The main issue here is that Risk-Adjusted Mortality Index
(Rami) data is incredibly murky.
Mr Millar, who represents Clwyd West, had also at one point issued a rebuke to outgoing vice-chairman of the board, Dr Lyndon Miles, over the accuracy of risk-adjusted mortality index
(RAMI) figures which showed an above-average death rate in Ysbyty Gwynedd.