The Child Healthcare Problem Identification Programme Child PIP

The Child Healthcare Problem Identification Programme Child PIP Monthly Mortality Review [enter name] Hospital Saving lives through death auditing Department of Paediatrics [Enter meeting date here]

The Child PIP ethos “The paediatric mortality review process seeks to improve the quality of care that children receive in [enter hospital name]

Meeting logistics • Minutes taker (and next week’s chairperson) • Cases to be presented and order • Code list distribution

Task Review: [enter last meeting’s date] Task Person Deadline Done

Ward [name]: Workload (Number of doctors =[enter number]) Number Rate per doctor Rate per day Admissions & Transfers in Discharges & Transfers out Deaths (to present) Phone calls for transfers Number of intake days = [enter number]

Ward [name]: Phone Calls (number of calls=[enter number] Number Comment Transferred Not accepted Advised Average time per call (minutes) % transfer sheets correctly filled in Number of intake days = [enter number]

Ward Month’s Tally: Admissions & Deaths AGE 0 - 28 DAYS- 1 YR 1 YR- 5 YRS- 13 YRS -18 YRS TOTAL ADMISSIONS DEATHS IHMR

Ward Month’s Tally: Nutrition CFR (under 5 only) AGE ABOVE 3 RD CENTILE UWFA SEVERE MALNUTRITION UNKNOWN TOTAL ADMISSIONS DEATHS IHMR

Ward Month’s Tally: ARI/DD CFRs (under 5 only) AGE ARI DD Other TOTAL ADMISSIONS DEATHS IHMR

Nursery Month’s Tally: Births & Deaths Weight 500 -999 g 1000 -1499 g 1500 -1999 g 2000 -2499 g >2499 g TOTAL Births Stillbirths NNDs PNMR

“It is absolutely essential to get the paper data management process right, BEFORE you start using the software”

Child PIP case discussions 1. Presenter • Case summary 2. Group • Cause of death • Modifiable factors Structure • Patient information • Presenting complaint Where did they occur? Who is responsible? • Background history • Home • Caregiver • Examination • Clinic • Manager • Problems and their progress • Transit • Healthworker • Hospital Inclusive Professional Confidential Respectful Creative Solution-directed

Case 1: Introduction • • Name: Age: Nutrition/weight/gestation classification: HIV classification: • Referred from: • Main reason for referral:

Case 1: History • Presenting Complaint (caregiver present? ) – What brought the child to hospital in the first place (NOT the referral letter) • Transit – Assessment, care plan, monitoring • Background – Pertinent points only

Case 1: Examination • General • Specific/focussed

Case 1: Problem list At admission 1. 2. 3. 4. 5. # # # # # During admission:

Case 1: Problems and Progress PROBLEM INVESTIGATIONS PROGRESS 1. # … … 2. # … …

Problems and Progress continued PROBLEM INVESTIGATIONS PROGRESS 3. # … … 4. # … …

Case 1: Causes of death Children Main Cause of death 1. …Diagnosis AND code 2. … Underlying condition Neonates Obstetric cause of death 1. …Diagnosis AND code 2. … 1. … Other diagnoses 1. 2. 3. 4. … … Neonatal cause of death 1. 2. 3. 4. … …

Case 1: Modifiable/avoidable factors Ward 1. 2. …MF AND code … 1. 2. … … A&E Transit Clinic Home Patient 1. 2. Nursery …AF AND code … Administrator 1. 2. … … Medical personnel 1. 2. … …

Case 1: Was the death avoidable 1. …yes/no/not sure Debriefing Tasks 1. 2. 3. 4. … …

New tasks Task Person Deadline Done

Closure • Date, time, place, chairperson for next meeting