Ashington audit series
| Parameter and methodology | Findings | Reference |
|---|---|---|
| Mortality: intrapartum deaths and deaths during the first 28 days of life for singletons born to mothers booked for delivery in Ashington. | 5.12/1000 singletons in 1991–5 before the introduction of the ANNP service: 3.11/1000 in 1996–2000, after the ANNPs came into post. For the whole Northern region, the reduction was from 4.10 to 2.99. | 2 |
| Confidential enquiry into quality of neonatal care review of 87 anonymised cases from Ashington and 5 comparator hospitals. | On six out of seven dimensions of quality, Ashington performed better than the average of the comparators and overall ranked second. | 10 |
| Quality of resuscitation at birth: independent case note review of 47 babies who took longer than 5 minutes to establish respiration. | No evidence of substandard care. | 2 |
| Grade 2/3 neonatal encephalopathy (NE) rate: case note review of all term babies with fits in first 7 days of life. | NE rate 18/14634 (1.23/1000): comparable to other recent studies (NB: neonatal encephalopathy rates reflect quality of obstetric care more than neonatal care). | 2 |
| Need for and review of transfer before and after delivery and management of transfer after delivery. | 97.5% of mothers booked for delivery in Ashington receive all their care and their baby’s care there. Babies born to 2.5% of women received some or all care at a regional centre; 44% of these were transferred before delivery. No evidence of increased morbidity associated with transfers. | 2 |
| Sensitivity and specificity of newborn clinical screening for congenital heart disease and congenital dysplasia/dislocation of the hip. Five year audit using regional database for structural heart disease; region’s hospitals for hip surgery. | Heart disease confirmed in 81/139 babies suspected of heart defect; 14 missed. Performance as good as or better than comparator units. Hip dysplasia: number/proportion of infants requiring surgery lower than any other comparator hospital and lower than the rate in the UK-wide study. | 2, 11 |
| Parent satisfaction with pre-discharge examination of newborn infant. Two studies, one face to face and one postal. Used 4 comparator units. | On 9 parameters, Ashington was ranked 1st, on two, 1st equal on one and second on six. | 12 |
| Communication: quality of discharge letters. Review by interview and questionnaire. | Parents are given a copy of the discharge letter. Ashington letters more timely, more accurate, and all parents valued them. Only one comparator unit gave a copy to parents. | 13 |
| Neonatal readmission within 28 days. | Third lowest in the region. Proportion readmitted to the unit where they were born was second highest in the region. | 2, 14 |
| Training: independent review. | Considered more satisfactory than in other reported studies. | 2, 15 |
| Staff stress: confidential report. | See text. | 2 |
| Costs: financial analysis. | Marginally lower than comparable units (see text). | 2, 9 |