Copeland’s Risk Adjusted Barometer (CRAB)

See the whole picture

CRAB is an innovative system for assessing, monitoring and improving the quality of care in hospitals.

It is unique because it uses pioneering methodology to predict the clinical risk for every patient as an individual,
rather than making assumptions based on national statistics.

This methodology has been developed over three decades and adjusts clinical outcomes
for the case-mix complexity of every patient treated.

The resulting analysis goes beyond crude mortality metrics, enabling clinicians,
managers and commissioners to understand morbidity and avoidable harm across the organisation.

CRAB helps you to see the whole picture.

Identify weaknesses

Identify weaknesses quickly and accurately and develop an action plan for remediation

Demonstrate quality

Demonstrate clinical excellence and contribute to continuing quality & innovation

Predict risk

Accurately assess patient risk at the point of admission, and optimise for better outcomes

Due diligence

Support due diligence activities when considering a merger or acquisition

What makes CRAB different from everything else?

CRAB provides full clinical case-mix adjustment, using 18 research-based clinical variables to calculate the specific risk of every patient.

As a result, mortality predictions have been shown to be up to four times more accurate than statistical models that use the Charlson index as a loose adjustment for risk.

CRAB is the only system to risk-adjust for complications as well as mortality, and to calculate risk-adjusted length of stay.

It is designed by and for clinicians, using data they trust. The solution is installed locally, and reports are typically three-six months ahead of external systems using central returns.

The patient-level analysis is more granular, going beyond Healthcare Resource Group (HRG) level coding and producing immediate root cause analysis data without the need to review patients' notes.

The resulting benefits are both clinical and financial. For example, at one trust complaints and litigation dropped by 10 per cent once it started using CRAB.

At CRAB Clinical Informatics Limited (C-Ci) we develop strong relationships with our clients, providing the support and advice they need to:

Implement C-Ci’s trusted systems

Train clinical teams and any other users

Establish a governance structure to review performance and report to the board

Understand and identify any weaknesses in patient care or highlight examples of excellent practice - and their root cause

Identify suitable remedial actions to improve quality and monitor ongoing performance

Correct any coding problems highlighted by CRAB

Not only do we produce monthly/annual summary reports for individuals, teams and the board, by using C-Ci systems our clients have found their consultants are more likely to review their own data.

Consultants regularly highlight instances of incorrect coding which are then reviewed by a benchmarking group, which can instruct the coding department to make changes and improvements.

In this way, common problems, such as incorrect procedure dates or attribution, or wrongly-coded complications (e.g. issues that were present on admission) are reduced. By using C-Ci systems our clients have been able to improve the quality of coding with direct clinical input.

Support is available around the clock via an online help forum. In addition, we will carry out an annual health check using the same methodology used by the Keogh Review of hospitals, to highlight any weaknesses and provide assistance with remediation planning.

As well as monthly reporting, C-Ci consultancy support is also available to help organisations understand and identify issues and their root cause. We then work with our clients on remedial action and help to monitor ongoing improvements.

Quick links


See how CRAB provides benefits across the whole organisation


Explore the different ways that CRAB is used to improve quality

Inspection report

A check-up on the quality of care delivery in your organisation

About us

Find out more about C-CI and the team

Recent Blogs

CRAB-Ci chosen by outstanding trust for its experience in real-time risk-adjusted indicators

CRAB Clinical Informatics has been awarded a contract with Royal Berkshire NHS Foundation Trust to deliver a set of tools supporting the trust’s clinical...

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Value over activity – putting value at the heart of care delivery

In recent years, payment for care services in the US has shifted from a focus on quantity to quality, with the aim of making...

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Using real-time risk to profile and predict morbidity risk

In the 1990s, when the move away from paper to electronic health records began, the paper process was merely replicated rather than using it...

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Professor Lord Darzi“CRAB can identify outcomes that are better than expected, as well as those that are worse, and thus can be used as an improvement tool as well as to assure clinicians and others of the standard of care being provided, and to measure productivity.”
Professor Lord Darzi

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