Nova Scotia

Rate of unexpected deaths drops at Cape Breton Regional Hospital

The rate of patients dying unexpectedly in Cape Breton Regional Hospital has gone down, according to new numbers.

Ratio provided by Canadian Institute for Health Information shows drop from 143 to 118

Cape Breton Regional Hospital no longer has the highest unexpected patient death rate in the country after officials made a concerted effort to improve patient care. (Tom Ayers/CBC)

Cape Breton Regional Hospital no longer has the highest rate of unexpected patient deaths in the country.

The latest figures from the Canadian Institute for Health Information show the hospital's standardized mortality ratio, or HSMR, has dropped from 143 to 118.

A hospital with a ratio of 100 is considered to be roughly equal to the national average.

Dr. Don Brien, an orthopedic surgeon at the hospital and medical executive director for Nova Scotia Health's eastern zone, said officials have made improvements in patient care and are not done yet.

"I think we have made some significant steps and it's nice to see that those steps we made have moved the HSMR needle," he said.

"Over the last year or two we've collected the data, we've analyzed the data, we've made these recommendations and now we're actually putting these recommendations into practice."

COPD, heart failure, sepsis top list

The Cape Breton hospital complex, which includes community hospitals in New Waterford, Glace Bay and North Sydney as well as the regional hospital in Sydney, has had the highest ratio in the country three years in a row.

The figure is a measure of unexpected deaths for patients in care.

Earlier this year, officials said the high ratio was mainly caused by chronic obstructive pulmonary disease, heart failure and severe infection, known as sepsis.

Dr. Don Brien is an an orthopedic surgeon at the Cape Breton Regional Hospital and medical executive director for Nova Scotia Health’s eastern zone. (Nova Scotia health authority )

Health officials said they were implementing a series of steps to try to address the situation, including several aimed at infection control.

Brien said the hospital is doing better at caring for people with heart failure and chronic respiratory disease. While the sepsis rate is continuing to climb, he said the number of deaths associated with severe infection is lower.

The plan is working and staff need to remain vigilant to identify and treat infection before it becomes a problem, he said.

"As a clinician working in the hospital, I really see a change from a year ago," Brien said. "There's a real heightened awareness now in the hospital."

Brett MacDougall, the eastern zone's executive director of health services, said he is pleased the death rate is going the right way, but he is not satisfied yet.

"We're happy to see improvements, but obviously there's still work to be done," he said. "We need to focus a bit more energy on our sepsis efforts."

Ratio shows where to improve

Jennifer Zelmer is CEO of Healthcare Excellence Canada, a national organization that advocates for patient care.

She said the numbers are good at showing where work is needed.

"There is no health-care organization on the planet who is perfect," she said. "We all have the opportunity to continue to improve our care."

However, Zelmer said, HSMR is only one indicator of patient care. Others include patient experience, readmissions and access to timely care.

According to the Canadian Institute for Health Information, the Cape Breton hospital complex fares about average in most of the other categories.



Tom Ayers


Tom Ayers has been a reporter and editor for 36 years. He has spent half of them covering Cape Breton and Nova Scotia stories. You can reach him at


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