Scottish Arthroplasty Project Outlier Process: Cumulative sum of outcomes (CUSUM) Outlier Governance Process

The Scottish Arthroplasty Project (SAP) provides quality assurance for the Scottish population and allows surgeons to monitor their surgical outcomes in terms of key performance indicators.

As part of the clinical governance process, it is recognised that some surgeons may have results that fall out with the main body of practice.

In these situations, it is important to analyse, in a collegiate manner, the reason for this. It is recognised that surgeons will have different patient populations and different scopes of practice. The purpose of the outlier process is to provide robust clinical governance and to advise and support surgeons.

The purpose of this document is to provide guidance for surgeons whose practice has been identified as having outlying data.