Risk modelling for quality improvement in the critically ill

Ensuring comparisons of health care providers are fair

Status: Analysis and report writing

What is this project about?

When patients are critically ill, it is usually an emergency situation, and patient choice rarely affects the decision as to where a patient is treated. It is therefore imperative to ensure that high quality critical care is delivered across all providers. An important process to facilitate this is clinical audit by assessing the outcome of care by comparison with other providers. It is essential that the process for making these comparisons takes into account the differing mix of patients treated in different institutions. For example, if one institution admits many more very sick patients, then one might expect the death rate in that institution to be higher. To do this, we use risk prediction models (also known as risk adjustment or case mix adjustment models). These statistical models take information about the patient known early in their illness and make a prediction of their likely outcome based on many thousands of patients.

The aim of this research study is to further develop and improve the risk prediction models that underpin ICNARC’s two national clinical audits – the Case Mix Programme and National Cardiac Arrest Audit. We have identified a number of areas with the potential to further enhance our modelling and develop new risk models and, with that, underpin quality improvement programmes for the critically ill.

When is it taking place?

The project started in July 2011 and finished in December 2014.

Who is leading the project?

Dr David Harrison, ICNARC

This project is funded by the National Institute for Health Research (NIHR) – Health Services and Delivery Research (HS&DR) Programme (Project: 09/2000/65)