We need to balance the technical challenges of hospital standardised mortality ratios with the need to improve care processes
That “sunshine is the best disinfectant” is attributed to the distinguished American jurist Louis Brandeis, who spent much of his career supporting individual rights in the context of corporate and monopoly power.1 State and federal governments, in conjunction with bodies such as the Australian Commission on Safety and Quality in Health Care and the Australian Institute of Health and Welfare, are developing indicators for the safety and quality of Australian hospital care, presumably with the intention of using them to illuminate some of the inner workings of our hospital system for the benefit of both health care providers and the community at large. The challenges posed by such a program are illustrated in this issue of the Journal by Scott and colleagues2 and Gallagher and Krumholz.3
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