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

Clinical Indicator Collection Internal Service Rate Based & Outcomes Indicators

NSW Perinatal Data collection

ACHS Obstetric Indicators

WHA Clinical Benchmarking Indicators

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

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

Promoting confidence in WHA benchmarks

• Forceps births

Promoting confidence in WHA benchmarks

• Caesarean Section

Promoting confidence in WHA benchmarks

• Blood Transfusion

Promoting confidence in WHA benchmarks

• Induction of Labour

Local Review of the 09/10 WHA Benchmarking Maternity Care Report

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

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

Flagged

• C/S and GA

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

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

Thank you