1. All Wales Qi Initiative Improving Badgernet Data Quality
Dr. Arun Ramachandran
Consultant Neonatologist
Singleton Hospital
Quality Group, Wales Neonatal Network

2. Badgernet electronic patient records (2011 – 2014)
Measures neonatal unit activity as per BAPM criteria
Provided data to South Wales Programme
Annual reports
Benchmarking – NNAP
Neonatal dashboard
Facilitates audits and quality improvement
Outputs only as good as the input data

3. EPIC concept of continuous quality improvement
Evidence based
Practice identification
Collaborative change
Continuous measurement

4. QI initiative launched 2011
Leadership from network subgroups
(Clinical informatics gr and Audit & Research gr)
Created evidence
- Pilot project in Singleton Hospital
- Strategy, Targets, Audit methods developed
and summarised in TIPS document
Badgernet champions identified in each Health Board for collaborative action
Local solutions encouraged
Information sharing via network meetings
Regular review of progress and feedback

5. Salient features Badgernet audit
Dynamic data ( affects unit activity ) – 15 items
Discharge summary – 26 items
NNAP quality – Local strategy to improve
Questionnaire survey of Badgernet leads for monitoring quality across Wales
Feedback to all hospitals via Wales Audit Days
Use of NDAU data quality feedback as an independent third party feedback

6. Data quality – NICU ( Level 3 units)
Hospital
Dynamic data for unit activity in %
(Target ≥ 90%)
Discharge summary in %
(Target ≥ 95%)
NNAP 4 index average in %
Singleton
2011/12
2013/14
92.2
98.8
96.6
96.2
95.75
Royal Gwent
92.5 95
92.15
UHW
83.3
94.2
No audit but monitoring +
89.5

7. Data Quality – LNU/SCBU in South Wales
Hospital
Dynamic data for unit activity in %
(Target ≥ 90%)
Discharge summary in %
(Target ≥ 95%)
NNAP 4 index average in %
RGH /12
2013/14
95.3 NA
81.6
94.2
94.75
PCH /12 96 57 81 87
POW /12
90.5
89.6 90
95.2 79
Glangwili /12
96.2
95.7
83.3
97.1
88.5
Nevill Hall /12
NA Audit +
NA Audit +
79.7

8. Data quality – Neonatal units in North Wales
Hospital
Dynamic data for unit activity in %
(Target ≥ 90%)
Discharge summary in %
(Target ≥ 95%)
NNAP 4 index average in %
Glan Clwyd
2011/12
2013/14
Audit + NA 83
Wrexam
Audit +
75.75
Ysbyty Gwynedd
(Bangor) 2011/12
< 90% . But improving
78.6

9. Summery
All neonatal units in Wales have undertaken Badgernet audits and quality improvement
Data from 3 tertiary units which provide > 50% of critical care in Wales are high quality
All other neonatal units in South Wales have improved and 3/5 have achieved targets
All units in North Wales are undertaking audits but data not comparable to South Wales due to variation in technique. Better synchronisation with the QI programme will accelerate improvement
Units with high Badgernet audit quality also have high NNAP data quality indicating robust system improvement with the QI programme