1. NATIONAL PERINATAL INFORMATION CENTER QUALITY 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

2. Presentation Background on NPIC/QAS Adverse Outcome Index Data Submission Process Reports

3. 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

4. Membership Data Base 22 th 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

5. 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

6. 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

7. 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. 3 rd or 4 th degree perineal laceration Adverse Outcome Measures (continued)

8. Weighted Adverse Outcome Scores Index Measure Score Maternal Death750 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 3 rd and 4 th degree perineal laceration 5

9. 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

10. 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

11. 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

12. Supplemental data set: perinatal variables Neonatal APGAR 5 Gestational Age Maternal Blood Transfusions if not coded MRN for linking to core data set

13. Adverse Outcome Index (AOI)

14. Weight Adverse Outcome Score (WAOS)

15. Severity Index (SI)

16. Questions/Comments?