c-ci

CRAB

Acute Medicine

Surgical operations tend to be well-defined, with reasonably clear outcomes. It is much more difficult to measure the quality of Medical care. Medical patients may suffer from a range of long term conditions which 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.

It can be as much an art as it is a science. So how can you measure it?

We have the answer.

There are recognised methods to assess different parts of the picture. For example:

• National Clinical Audit programmes. These tend to analyse processes of care which have a direct impact on a patient’s health (for example, door-to-needle time for Myocardial Infarction, or timeliness of admission and C.T. scan for stroke patients);
• The IHI Global Trigger Tool. The GTT is an internationally respected system to support a detailed review of where there is evidence of potentially harmful actions. This was first published by the Institute for Healthcare Improvement in the US. A UK version of this has been developed and is freely available. It is being championed in England by the NHS Institute for Innovation and Improvement. The UK Global Trigger Tool looks at 32 “trigger” events which are indicative of iatrogenic harm. An understanding of where these triggers appear can lead to a clear plan for changing process, practice and governance to improve quality and safety.

But there are inherent problems with these methods in their current form.

• National Audits are only carried out infrequently - they don’t represent a real-time picture of care locally so it’s difficult to make the results actionable.
• By contrast, the Global Trigger tool produces actionable reports. But is very expensive and labour intensive, relying on a committee of expert clinicians manually reviewing sets of patients notes for clues.
• and both approaches focus on small samples of patients.

But what if you could combine these assessments? In real time, all the time? For all medical patients? Automatically?

You can.

The solution.

C-CI has developed a unique new system which has reviewed the UK version of the Global Trigger Tool and automated the process. We can report 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.

Our reporting can be supplemented where appropriate with key audit criteria for effective care. It can also be case-mix adjusted using CRAB physiological profiling to understand the inherent state of health of the patients treated and any underlying diagnoses which may be a cause of complications.

The results can add real value:

• for physicians – for appraisals and revalidation, and clinical research;
• for the organisation - for clinical governance assurance and quality improvement programmes.

And if your Trust is already implementing the Global Trigger Tool manually, CRAB can save you clinical time and money.