Tracking avoidable harm

Surgical operations tend to be well defined, with reasonably clear outcomes, but it is much more difficult to measure the quality of medical care.

Medical patients may suffer from a range of long-term conditions that will affect their state of health over a number of years with no end point.

They may be treated by a number of different physicians over time, or at the same time. So how can you measure the quality of medical care?

The Medical module is the only system to produce automated tracking of the indicators of avoidable harm, drawn from the UK Global Trigger Tool, to assess the quality of front-line care across an organisation.

The results can add real value for physicians as well as the wider organisation.


CRAB Medical reports on trigger events for all patients, by specialty, by physician,
and over time to give a comprehensive picture of quality and trends in medical care.

Track avoidable harm

Reports on trigger events for all patients, by specialty and by physician.

Performance assessment

Better analysis of the performance of clinical staff (including ward staff).


Support for clinical governance assurance and quality improvement programmes.

Tracking avoidable harm

Triggers are events during a patient’s hospital stay that may have resulted from hospital based ‘harm’. The Medical Module assesses every in-patient admission using HES coding to identify validated surrogates that map to these trigger events.

In many such cases there are direct coding relationships, but in others complex combinations of HES codes with the process of episodes of care are used to identify the trigger.

The triggers are combined into modules: general, surgical, intensive care, medication and laboratory tests, and investigation is possible by department, specialty and individual consultant.

CRAB has built up norms for all triggers and combinations of triggers with our knowledge of changes in these indicators. With known individual clinician and institutional based anomalies it is possible to identify variations in triggers which can be associated with potential deteriorations in practice and hence outcome.

Data can also be interrogated using physiological profiling to understand the inherent state of health of the patients treated and any underlying diagnoses that may be a cause of complications. Reporting can be supplemented, where appropriate, with key audit criteria for effective care.


Alison Diamond, Medical Director, Nothern Devon Healthcare NHS Trust“CRAB has provided data for the consultants to really understand their outcomes for patients in a user friendly way.”
Alison Diamond, Medical Director, Nothern Devon Healthcare NHS Trust
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