Benefits to Executives and Managers
Information is one of the most important resources available to managers. Yet obtaining truly meaningful and independent information can be a challenge, particularly in a large and complex organisation, with multiple specialist fields.
he CRAB clinical audit software takes data from a variety of sources and provides a detailed picture of the quality of care across the organisation, benchmarked against the largest database of clinical outcomes of its kind in the world.
The result is the truly meaningful analysis that managers, executives and boards need to pinpoint the risks of avoidable harm, and highlight poorly performing individuals and teams.
Decisions can be made with the clarity that comes from analysis that is accurate, impartial and objective.
CRAB enables hospital managers and administrators to improve quality in a number of different areas.
Understand care quality in your organisation
Is quality reported to you simply on the basis of mortality rates and readmissions? The true picture may be very different (click on the image to enlarge).
CRAB shows the difference between unadjusted mortality and the true picture when case-mix and complexity of patients treated is taken into account.
Notice that in the period when overall mortality is at its highest, case-mix adjusted quality is nevertheless good. Points plotted below the yellow line represent better than predicted outcomes, benchmarked against international as well as UK practice.
Do you know which teams in your hospital are delivering best quality? Do you have the evidence to market good performance and reward best practice?
CRAB is unique because it can show you the best outliers, by showing where excellent results are being delivered even for the most difficult cases.
Quality can now be demonstrated in a uniquely positive way, and specific specialties, sub-specialties or even units and individuals singled out for praise.
Make effective use of critical care facilities
HDU and ITU beds are frequently in short supply. This graph shows a three-month facilities trend report (click to enlarge).
This is not an uncommon picture, but the answer doesn’t have to be an expensive capital investment in new facilities.
Hospitals have used CRAB effectively to achieve the same results by understanding individual patients’ care needs and reconfiguring nursing resource more efficiently.
Identify problems before they escalate
Most systems will show alerts, some more prolifically than others, based on statistical assessments on mortality and complications.
They are driven by data that is often months behind which can be time-consuming to investigate only to discover that it was a false alarm.
CRAB uses on-site real-time data (click on the image to enlarge). It gives you the tools to know when something may be going wrong, even on the basis of a handful of cases, and to rapidly find out the root cause.
How fit for purpose are your current systems for assuring the board of safety and quality?
CRAB generates automatic quarterly reports for boards and senior management to understand the true picture of clinical performance in the organisation.
Download a sample board report here.
Respond to external allegations
Click here to read how County Durham & Darlington NHS Foundation Trust used CRAB to defend its reputation from an external organisation and saved and money in the process.
Click here to read how a NHS trust was able to exonerate a clinician who had come under suspicion following external mortality analysis.
Quality improvement at an NHS Trust
NHS Litigation Authority
CRAB software has enabled the trust to progress its application for Level 2 NHSLA status and it is confident that the software will assist progression towards Level 3. The trust would be able to generate a saving of circa £200,000 by meeting Level 2 with a further £200,000 should Level 3 be achieved.
Activity has been coded to a greater depth as a result of using CRAB in the trust’s clinical benchmarking group. The group looks at monthly reports and any alerts CRAB raises which require additional assessment.
This has encouraged dialogue between clinicians and clinical coders on how respective episodes of care should be coded. As a result the Trust’s coding has increased accuracy which in turn has had a positive effect on the funding the Trust receives.
The mortality rates and complications rates of the Trust continue to improve and the introduction and use of CRAB has made a positive contribution towards this.
Foundation Trust application
In our foundation trust application we highlighted CRAB as an example of proactive risk management and how subsequently we developed a clinical benchmarking group to use the software to manage clinical variance.
Monitor was very impressed with this approach and we were able to state that CRAB allowed the Trust to make more timely interventions when required.
Furthermore, the tighter confidence intervals that resulted from using CRAB meant that a great deal more clinical alerts were highlighted than would have been when using, for example, Dr Foster.
At the 'board to board' meeting the medical director highlighted our use of CRAB for clinical risk management, and we received positive comments regarding how proactive we had been in this area.
Commissioning for quality and innovation
The Trust was able to secure circa £96,000 revenue in 2009/10 from the PCT for the development of the CRAB software suite - 0.1 per cent of the contract value.
To read more Case studies click here.