An ICU is considered a potential outlier if the units standardised mortality ratio (SMR) falls outside of the control range for their classification. The control range is given by the 99% confidence intervals around the SMR for the ICU’s peer hospital group (tertiary, metropolitan, regional/rural, private). There are many reasons that this may occur, and the Outlier Management Program exists to assist ICUs in understanding the underlying reasons that may be contributing to the higher SMR.
The potential outlier review is a structured process of analysis and reporting, undertaken to better understand the likely contributors, which generally fall into three broad categories – data quality, case mix and resourcing/processes of care.
The ANZICS Outlier Working Group (OWG) provides the clinical and statistical oversight of the review process for the adult ICUs contributing to the Adult Patient Database (APD) , while the ANZPIC Registry Clinical Advisory Committee (ARCAC) for the paediatric ICUs contributing to the ANZPIC Registry.
ANZICS CORE Reporting guidance for ICUs to explore their Standardised Mortality Ratio