Hi Kerry. I co-ordinate a mortality review programme and therefore familiar with use of the RPsych Care Review Tool template for care record review to explore and consider harm. Their guidance indicates additional prompts can be added to the tool if a Trust wishes to explore a particular cohort - eg dementia. But it sounds like you are applying harm review to living patients. One option would be to produce a mini case comparison tool, defining the kind of harms you are looking for (ie is the focus purely on physical and or mental health or would you be thinking broader from a public health perspective and take into account social determinants), you can review each case to confirm whether that indicator is present. Simple but visual. Not sure how you could define harm in this context - perhaps better to describe as risk factors or health determinants?