Background: Excess inpatient mortality is a marker of poor quality in cancer care. We developed a multidisciplinary mortality review committee to review each inpatient death to determine key drivers of mortality and develop targeted interventions to reduce our inpatient mortality index. Methods: Through retrospective review, inpatient deaths were identified at Stanford Health Care for patients with an ICD10 cancer diagnosis regardless of inpatient service. Details of each hospitalization were reviewed by a quality consultant and subsequently reviewed by a physician quality team member to identify opportunities for improvement. Most cases were then discussed in a monthly multidisciplinary committee meeting. The committee analyzed key drivers of inpatient mortality, communicated suggestions to the patient’s outpatient and inpatient attending physicians, and/or identified opportunities for systemic change. The resulting targeted interventions were tracked using the observed versus expected mortality ratio for inpatient deaths over time. Results: From May 2017 through August 2021 we reviewed 528 inpatient oncology deaths. Patients’ median age was 65 years, and the median length of stay was 8 days. 73% of patients had metastatic cancer, and 28% received chemotherapy within 14 days of death. 25% of patients had a prior ED visit, and 35% had a prior hospitalization within 30 days of admission. Only 26% of patients had an advanced directive on record at time of death. Opportunities for improvement were identified for 60% of cases (Table). Interventions have aimed to increase advance care planning conversations and documentation, develop predictive models for cancer-related readmissions and mortality, expand outpatient services for urgent symptoms, and expedite transitions to hospice. Conclusions: Understanding key drivers for preventable inpatient mortality through a multidisciplinary review process identified targeted interventions that have successfully contributed to reduction of the inpatient cancer mortality index.