This report examines how the hospital standardised mortality ratio (HSMR) can be used as a potentially valuable tool to reduce avoidable mortality in acute hospitals. The report acknowledges and contributes to the ongoing debate over the use of HSMR as a measurement approach.

It provides a useful guide to understanding and using HSMR, along with a toolkit of practical suggestions. Of particular use, the report examines the key steps involved in responding to HSMR measures as opportunities for improvement.