NATIONAL PERINATAL INFORMATION CENTERQUALITY ANALYTIC SERVICES

Janet H. Muri, Vice President

225 Chapman Street, Suite 200

Providence, Rhode Island

(401) 274-0650

A non-profit membership and research company serving the perinatal community

The Maryland Patient Safety Center

Perinatal Collaborative: Improvement Lead Workshop

January 25, 2007

Presentation

Background on NPIC/QAS

Adverse Outcome Index

Data Submission Process

Reports

Background

• Incorporated in 1985, 501 (c) (3)

• National Board of Directors

• Membership Data Base - Perinatal Center Data Base (PCDB)

• Evaluation and Research Services

• International Services

• Contract/ Consulting Services

Membership Data Base• 22th year

• 1.4 million discharges year annually

• 700,000 perinatal discharges per year

• Level II & III hospitals

• Quarterly Reports

• Ad hoc reports/special comparative analyses

Team Performance Plus (TPP)Harvard Team Training Collaborative

• Data Collection and Processing for TPP using administrative data with supplemental file

• Baseline Report 4-8 quarters before training

• Ongoing Quarterly Monitoring Report-post training

• Profile 10 Adverse Outcome Events

• Compared to NPIC/QAS Benchmark & Target Benchmark

1. Maternal Death

2. Intrapartum or Neonatal Death >2500 grams (within 7 days of birth)

3. Uterine Rupture (Identified in laboring patients)

4. Unplanned Maternal admission to ICU

5. Birth Trauma

Adverse Outcome Measures

6. Return to OR/Labor and Delivery

7. Unplanned admission to NICU>2500grams within 24 hours for >24 hours

8. APGAR 5 <7

9. Maternal Blood Transfusion

10. 3rd or 4th degree perineal laceration

Adverse Outcome Measures (continued)

=

Weighted Adverse Outcome Scores Index Measure Score

Maternal Death 750

Intrapartum and Neonatal Death 400

Uterine Rupture 100

Maternal Admission to ICU 65

Birth Trauma 60

Return to OR/L&D 40

Admission to NICU 35

APGAR <7 25

Blood Transfusions 20

3rd and 4th degree perineal laceration 5

Three Indices I. Adverse Outcome Index (AOI) - # patients with one

or more adverse outcomes / total number of deliveries II. Weighted Adverse Outcome Score (WAOS)- total

weighted adverse outcome score/ total number of deliveries

 III. Severity Index (SI) – total weighted adverse

outcome score/ # of patients with an adverse outcome

Data Submission Process

• Administrative and Technical Contact

• Business Associate Agreement and Contract

• Baseline Data 2-4 quarters of CY 2006 data

• Monitoring Data: 2-4 quarters of data starting with 10/1/07 discharges

• Administrative discharge abstract data with supplemental perinatal variables

Data Files- Core Data Set

• Hospital IS Department/HSCRC or DCHA data file

• MDC 14 or all discharges 0-28 days old admission

• Electronic submission to secure website

Supplemental data set: perinatal variables

• Neonatal APGAR 5

• Gestational Age

• Maternal Blood Transfusions if not coded

• MRN for linking to core data set

Adverse Outcome Index (AOI)

Weight Adverse Outcome Score(WAOS)

Severity Index (SI)

Questions/Comments?