ALL WALES QI INITIATIVE IMPROVING BADGERNET DATA QUALITY

ALL WALES QI INITIATIVE IMPROVING BADGERNET DATA QUALITY Dr. Arun Ramachandran Consultant Neonatologist Singleton Hospital Quality Group, Wales Neonatal Network

Badgernet electronic patient records (2011 – 2014) • • • Measures neonatal unit activity as per BAPM criteria Provided data to South Wales Programme Annual reports Benchmarking – NNAP Neonatal dashboard Facilitates audits and quality improvement Outputs only as good as the input data

EPIC concept of continuous quality improvement Evidence based Practice identification Collaborative change Continuous measurement

QI initiative launched 2011 Leadership from network subgroups (Clinical informatics gr and Audit & Research gr) Created evidence - Pilot project in Singleton Hospital - Strategy, Targets, Audit methods developed and summarised in TIPS document Badgernet champions identified in each Health Board for collaborative action Local solutions encouraged Information sharing via network meetings Regular review of progress and feedback

Salient features Badgernet audit Dynamic data ( affects unit activity ) – 15 items Discharge summary – 26 items NNAP quality – Local strategy to improve Questionnaire survey of Badgernet leads for monitoring quality across Wales Feedback to all hospitals via Wales Audit Days Use of NDAU data quality feedback as an independent third party feedback

Data quality – NICU ( Level 3 units) Hospital Dynamic data for unit activity in % (Target ≥ 90%) Discharge summary in % (Target ≥ 95%) Singleton 2011/12 92. 2 96. 6 2013/14 98. 8 96. 2 Royal Gwent 2011/12 92. 5 95 2013/14 95 95 2011/12 83. 3 No audit but monitoring + 2013/14 94. 2 NNAP 4 index average in % 95. 75 92. 15 UHW 89. 5

Data Quality – LNU/SCBU in South Wales Hospital Dynamic data for Discharge NNAP 4 index RGH PCH POW Glangwili Nevill Hall unit activity in % (Target ≥ 90%) summary in % (Target ≥ 95%) 2011/12 95. 3 81. 6 2013/14 NA 94. 2 2011/12 NA 57 2013/14 96 81 2011/12 90. 5 90 2013/14 89. 6 95. 2 2011/12 96. 2 83. 3 2013/14 95. 7 97. 1 2011/12 NA 2013/14 NA average in % 94. 75 87 79 88. 5 NA Audit + 79. 7

Data quality – Neonatal units in North Wales Hospital Dynamic data for unit activity in % (Target ≥ 90%) Glan Clwyd 2011/12 Discharge summary in % (Target ≥ 95%) NNAP 4 index average in % NA 83 Audit + 2013/14 NA 2011/12 Audit + 2013/14 NA NA 75. 75 < 90%. But improving 78. 6 Wrexam Ysbyty Gwynedd (Bangor) 2011/12 2013/14

Summery All neonatal units in Wales have undertaken Badgernet audits and quality improvement Data from 3 tertiary units which provide > 50% of critical care in Wales are high quality All other neonatal units in South Wales have improved and 3/5 have achieved targets All units in North Wales are undertaking audits but data not comparable to South Wales due to variation in technique. Better synchronisation with the QI programme will accelerate improvement Units with high Badgernet audit quality also have high NNAP data quality indicating robust system improvement with the QI programme