Perinatal mortality & morbidity Audit

Perinatal Mortality and Morbidity (PNM&M) Audit Project

The PNM&M project was piloted in Victoria in 2004/05, conducted in rural Queensland and NT in 2005 /06 and to NSW Provincial Fellows in 2006/07. RANZCOG has received new funding under the SSRS scheme to complete the audit cycle in SA and WA in 2008 .

The project seeks to improve the audit, investigation and peer review skills of regional and rural obstetricians and paediatricians who have been involved in perinatal adverse events (“near misses”) that have resulted in a transfer to a neonatal intensive care unit or a perinatal death.

Update

Invitations were sent to all SA and WA O&Gs and Paediatricians to participate in this project, and Fellows from other States were also invited to act as facilitators. Fifteen rural specialists have agreed to participate in this project.

A training day will be held in Perth on Friday 8 February 2008 for all participants. Issues such as root cause analysis, giving feedback, coaching and writing reports will be covered as well as an overview on the methods of data collection used by WA Health and the use of the PSANZ guidelines.

Seven sites in regional and rural SA and WA have volunteered to host a visit with external facilitators carrying out retrospective audits of medical records that fit within the inclusion criteria. These are scheduled to occur between March and August 2008.

The visits consist of one full day to carry out the review of records, interview the unit staff, provide feedback on clinical and systems issues and develop an action plan for improvement in collaboration with the clinicians involved.

A follow-up videoconference for all participants is planned.

Overview

To date, there has been a range of approaches to investigating perinatal mortality. We are seeking to develop a more standard and nationally understood approach to investigating and improving clinical practice and systems that surround perinatal deaths.

This project aims to promote the idea of peers visiting others to facilitate the investigation of perinatal deaths and help in developing action plans for improvement.

The Perinatal Mortality and Morbidity (PM&M) Audit project was piloted in different regions in Victoria , South Australia and northern Tasmania in 2004. Six visits were carried out with over 50 perinatal deaths reviewed.

The PM&M project has continued across Australia following the success of the pilot project.

2008 project

Following the success of the perinatal audits of obstetric units in Victoria , South Australia , Tasmania , Queensland , Northern Territory and NSW in 2004, 2005 and 2006, the college has received funding to extend the project to regional and rural WA and SA.

Who's Involved?

Collaborators

The project is a collaboration between:

• The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and
• The Royal Australasian College of Physicians (RACP) (Paediatrics and Child Health Division)

What's Involved in the PM&M Audit?

By joining as an audit facilitator you will:

• Get access to a range of tools and guidelines on how to carry out perinatal audit
• Attend a one day workshop on audit investigation and feedback skills (travel and accommodation expenses paid for) in Perth on 8 February 2008
• Visit another regional health service and facilitate an audit over one day
• Participate in a debrief session (via teleconference).

Fellows being audited will:

• Get peer review in the area of perinatal mortality
• Develop an action plan on how you might improve your own practice
• Participate in a follow-up event six months after the audit, if required

Why Participate?

Be part of an innovative project to improve your skills and the practice of others. This is a great way to contribute to your own work and to give others the benefit of your skills and knowledge.

We acknowledge that this work will help you to develop your own practice. You will also be able to earn CPD points for the workshops and the visits you do. RANZCOG Fellows can earn 8 PR&CRM points for receiving an audit visit. Audit facilitators will receive 25 PR&CRM points.

Indicative Timeline for 2008

2008 timeline

Qualified Privilege

Safeguarding information and practitioners

This project is covered under the Commonwealth Qualified Privilege Scheme. This encourages health professionals to undertake efficient quality assurance activities in connection with the provision of certain health services. The Scheme has been designed to provide important safeguards by protecting certain information from disclosure and protecting persons involved in the activity from civil liability.

The Commonwealth Qualified Privilege Scheme under Part VC of the Health Insurance Act 1973 is designed to remove these fears and encourage health care professionals to participate in quality assurance activities by providing:

• for the confidentiality of most information that identifies individuals and which becomes known as a result of declared quality assurance activities
• protection from civil proceedings (apart from those relating to the rules of procedural fairness) for members of committees that assess or evaluate the quality of health services provided by others.

For Further Information

Contact the Project Manager

For further information please contact:

Anna Maloney

Project Manager
RANZCOG

Ms Dot Willmott

Project Co-ordinator
RANZCOG

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