Move Your Dot™: Measuring, Evaluating, and Reducing Hospital Mortality Rates (Part 1)

How to cite this paper:

Move Your Dot™: Measuring, Evaluating, and Reducing Hospital Mortality Rates (Part 1). IHI Innovation Series white paper. Boston: Institute for Healthcare Improvement; 2003. (Available on


See the "Reducing Hospital Mortality Rates (Part 2)" white paper for an update on IHI's work to reduce mortality first introduced in this "Move Your Dot" (Part 1) white paper.
IHI’s Innovation Series white papers were developed to further our mission of improving the quality and value of health care. The findings and tools in these reports provide you with an opportunity to understand and evaluate the issues, and begin testing changes that can help your organization make breakthrough improvements.
Move Your Dot™ is an effort to help hospitals know more about their organizational performance as it relates to mortality. A new statistical methodology has been developed to standardize hospital mortality rates in order to fairly compare them. Further, a simple analytical tool has been developed to help hospitals evaluate their mortality rate — their "dot" on a scatterplot of mortality rates for US hospitals — and analyze the factors that contribute to it. This analysis can lead to targeted quality improvement projects that can "move the dot" — that is, reduce hospital deaths.
Move Your Dot™ is one of many current approaches being used to improve health care safety throughout the health care system. This movement is in large measure the result of studies published in the last decade revealing the extent of harm caused to patients by medical errors, and outlining a broad prescription for change.
Concurrent with the industry's efforts to improve care, purchasers and consumers are increasingly focusing on information about quality to choose providers. "Report cards" detailing process and outcomes data are increasingly available at the health plan, hospital, and provider group levels.
In addition to feeling the professional imperative to provide the highest quality care, hospital executives are also feeling competitive pressure to demonstrate quality by publishing outcomes data. A measure that carries significant emotional weight, as well as important implications about quality, is a hospital's mortality rate.
As part of its effort to foster improvement in the US health care system, the Institute for Healthcare Improvement is offering the newly developed Move Your Dot™ analytical tool to any hospital interested in using it to measure and analyze their mortality rate. IHI also has mortality rate data for all US hospitals and can provide a hospital with its mortality rate on request.
The tool, used to date by more than 25 hospitals to assess and analyze their mortality rates, has proved useful in helping institutions identify opportunities for improvement. Aggregate data compiled by the hospitals participating in this effort will be sent to all hospitals that provide their data to IHI.
Health care leaders are driven by an intrinsic commitment to excellence. Through this Innovation Series white paper, IHI hopes to support this commitment by helping health care leaders understand how reducing hospital mortality rates can improve health care safety and the quality of care delivered to all patients.


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