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Prepared by Ruth ClarkMaternity Services Data Manager
Central Coast LHD
May 2012
Using WHA’s Benchmarking Data
Revealing the results of the 09/10 WHA Maternity Care Report to clinicians at Gosford Maternity Service
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Clinical Indicator Collection Internal Service Rate Based & Outcomes Indicators
NSW Perinatal Data collection
ACHS Obstetric Indicators
WHA Clinical Benchmarking Indicators
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Clinical Indicator Ownership Understand the system we work in
Compare our service with external measures
Recognise and celebrate excellence
Determine where to undertake detailed analysis
Examine the underlying causes for undesired outcomes
Design changes to improve the system
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Clinical Indicator Ownership – confidence in benchmarking
Assist all levels of staff to understand value of benchmarking
Make CIs easy to interpret.
Present local CIs regularly and compare often
Encourage discussion and disagreement
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Promoting confidence in WHA benchmarks
• Forceps births
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Promoting confidence in WHA benchmarks
• Caesarean Section
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Promoting confidence in WHA benchmarks
• Blood Transfusion
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Promoting confidence in WHA benchmarks
• Induction of Labour
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Local Review of the 09/10 WHA Benchmarking Maternity Care Report
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Doing Well
• NBAC successful trial of labour
• VB and PPH• C/S and PPH• Blood transfusion
Stable
• Liveborn babies gest <32 weeks
• Liveborn term babies HIE grade 2 or 3
Improving
• C/S rate all women
• Selected primips vaginal births
• NBAC vaginal birth
• Elective repeat C/S
• 3rd & 4th degree tears
Review of 09/10 WHA Benchmarking Maternity Care
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Flagged for Immediate Attention
• C/S and General Anaesthetic• Vaginal birth and epidural• Selected primips induced• Selected primips having spontaneous labour and unassisted birth• Liveborn term babies with apgar 6 or less at 5 minutes
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Flagged
• C/S and GA
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Flagged
• Selected primips induced
• Selected primips and normal birth
Preliminary audit findings
• 29% for gest >=41 weeks
• 27% for Prelabour ROM
• 6% diabetes• <2% social
Early recommendations
• Review home management of ROM program
• SS review of birth plans in diabetes clinic
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Flagged
• Vaginal birth and epidural
Audit findings
• Maternal request• Rates lower in
MMOC
Recommendations
• Increase staffing of MMOC to care for more women
• Increase 1:1 midwife care in labour
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Thank you