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.

CRAB is unique in predicting the clinical risk for every patient as an individual, rather than making blunt assumptions based on national statistics.

Using a pioneering methodology that has been three decades in the making, clinical outcomes are adjusted 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 each and 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.

CRAB is designed by and for clinicians, using data they trust. The solution is installed locally, and reports are typically 3-6 months ahead of external systems using central returns.

The patient-level analysis is more granular, going beyond 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% following the introduction of CRAB.

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

Case Study – How CRAB is helping to monitor clinical performance, benchmark quality and identify surgical trends.

St Helens and Knowsley Teaching Hospital began using the CRAB surgical module over three years ago. Sunjay Kanwar, Consultant General/Upper GI Surgeon, believes CRAB...

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Royal National Orthopaedic Hospital NHS Trust; leading the way for tertiary referral centres

  C-Ci is delighted to welcome on board the RNOH who after carrying out an initial CRAB Inspection Report have decided to implement CRAB...

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Hospital trusts are to carry out a self-assessment of avoidable mortality to help create a new organisation level “avoidable deaths” figure.

  Sir Bruce Keogh, NHS England’s Medical Director has written to the Medical Directors of every hospital trust in the country outlining the steps...

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Professor Lord Darzi"Whilst existing outcome data is sometimes mistrusted by clinicians, there are more sophisticated outcome measures being developed all the time. For example, Copeland's Risk Adjusted Barometer - based on the widely-recognised POSSUM scoring system14 - relies on locally-collected data (improving its accuracy) and incorporates a sophisticated analysis of a patient's presenting risk, together with an assessment of the complexity of the operation and any complications that arise during the operation. It 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." Healthcare for London: A Framework for Action
Professor Lord Darzi

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