Making Every Baby Count

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Annex 8b. Guidance for completing the Stillbirth and Neonatal Mortality Audit – Meeting Minutes and Action Items Form Steps for minute-taking at perinatal mortality audit meetings (also known as perinatal death review meetings): 1. Use this form to capture the minutes, which should be accompanied by the code of practice declaration signed before each meeting (see Annex 6) and the attendance register signed at the end of each meeting. 2. The meeting chairperson is responsible for ensuring that the minutes are taken, and that the form is filled in at the end of the meeting. Do not leave the filling of the form for a later time. For the minutes to be a functional document, the filling of the form needs to be part of the meeting process. 3. The statistics can be filled in on the form during preparations in advance of the meeting. If more extensive statistics are presented at the meeting, it is optional to attach a copy of the presentation as an addendum to the minutes. 4. Enter a one-line summary about each case presented. For example: “Case X.N., No. 45368, intrapartum stillbirth 2.5 kg, ruptured uterus”. It is not necessary to include a full case report. If requested, case presentations can be attached as an addendum to the minutes. 5. The chairperson should allocate at least 5 minutes at the end of the meeting to summarize the key problems that have been identified during the meeting, based on the presentation of statistics or the cases discussed, or both. 6. Based on these problems, action plans can be drawn up, as outlined on the table on the second page of the form. The task list should be clearly allocated and agreed upon at the meeting. 7. At the end of the meeting, the chairperson should ensure that the minutes form is fully complete, either on paper or electronically. Only the follow-up section of the table should be left blank. 8. Within 72 hours of the meeting, paper-based minutes should be typed up and stored electronically. This should not be a long task if the format of the template is adhered to. The typed minutes should be verified by the chairperson, and then circulated as draft minutes by email to all members on the attendance list for the meeting, other interested stakeholders and anyone with responsibility for one of the tasks in the action plan. The distribution of the draft minutes should be completed within a week of the date of the meeting. 9. At the following perinatal mortality audit meeting, the chairperson should allocate some time for reviewing the draft minutes of the previous meeting, preferably at the start of the meeting. If a task has not been completed, this should be noted in the follow-up column and the task can be carried over into the action plans table for the current meeting. Once the follow-up column from the minutes of the previous meeting has been filled in, those final minutes can be ratified, with a proposer and a seconder. 10. The meeting can then proceed with new statistics and/or case presentations. 102 MAKING EVERY BABY COUNT: AUDIT AND REVIEW OF STILLBIRTHS AND NEONATAL DEATHS
Annex 9. Steps for establishing a mortality audit for stillbirths and neonatal deaths Mortality audit (also known as “death review”) is a process to document the medical causes of each death and the contributing systemic failures across many cases, to identify solutions and to take action. It is not a solution in itself. It is a systematic way of improving quality of care by collecting and analysing data, linking solutions to identified problems, and ensuring accountability for changes to improve care. 1. Identify perinatal deaths 6. Evaluate and refine 2. Collect information 5. Implement recommendations 3. Analyse results 4. Recommend solutions MAKING EVERY BABY COUNT: AUDIT AND REVIEW OF STILLBIRTHS AND NEONATAL DEATHS 103
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Making Every Baby Count Audit and r
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Making Every Baby Count Audit and r
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4.3 The six-step mortality audit cy
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Acknowledgements The World Health O
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Foreword Pregnancy is a time of gre
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in the future. The process of routi
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Key messages of this guide • Audi
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1 Getting started
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1.2 Why is this guide important? Co
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Importantly, it is not sufficient t
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2 Definitions and classification Th
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There are also numerous ways to app
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TABLE 2.1. Mortality rate definitio
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application of ICD-10 to deaths dur
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Box 2.1. Background and contextual
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• Family- or patient-related: e.g
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3 Auditing deaths that occur at the
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Within each facility, at least two
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compared to the actual numbers of r
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of events that led to death, text b
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• the number of antepartum (or ma
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Possible actions include interventi
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Step 6: Evaluating and refining The
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4 Auditing deaths that occur in the
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(e.g. individuals who conduct routi
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The most effective mechanism for in
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Step 1.2: Notification and reportin
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It may be easier for an information
Page 58 and 59: Geospatial analyses may be very ben
Page 60 and 61: 5 Creating an enabling environment
Page 62 and 63: will help facilitate the process fo
Page 64 and 65: Maternal and Perinatal Death Review
Page 66 and 67: 6 Scaling up audit for quality and
Page 68 and 69: FIGURE 6.1. Dimensions of a phased
Page 70 and 71: FIGURE 6.2. Example of data flow in
Page 72 and 73: References 1. Maternal death survei
Page 74 and 75: 39. Bradshaw D, Chopra M, Kerber K,
Page 76 and 77: Annexes Annex 1 Stillbirth and Neon
Page 78 and 79: 3.6 Fetal heart sounds on admission
Page 80 and 81: Annex 1b. Guidance for completing t
Page 82 and 83: • “unknown” if the total numb
Page 84 and 85: • If fetal heart sounds were not
Page 86 and 87: -- If a “delay 1” is present, c
Page 88 and 89: . antepartum complications Annex 2:
Page 90 and 91: Annex 2b. Guidance for completing t
Page 92 and 93: 2.1b: Cause of death - intrapartum
Page 94 and 95: Annex 3b. Guidance for collecting t
Page 96 and 97: 3) If there is no gestational age e
Page 98 and 99: Annex 4. Approaches for classifying
Page 100 and 101: There are multiple tools available
Page 102 and 103: to their occurrence - are entered o
Page 104 and 105: Annex 6. Sample mortality audit mee
Page 106 and 107: Annex 8: Stillbirth and Neonatal Mo
Page 110 and 111: Steps 1. Understand the steps of th
Page 112 and 113: INFORMED CONSENT FORM (INTERVIEWEE
Page 114 and 115: SEQUENTIAL NUMBER SECTION 1. INTER
Page 116 and 117: SECTION 3. INFORMATION ON THE DECEA
Page 118 and 119: ASK THE RESPONDENT: What do you thi
Page 120 and 121: 4.4.2 Before the woman became pregn
Page 122 and 123: 4.16.2 During the last 3 months of
Page 124 and 125: 5.5 How many hours or days passed b
Page 126 and 127: 5.18 Would you say the baby’s siz
Page 128 and 129: 5.33 Did the baby ever move, even a
Page 130 and 131: SECTION 6. NEONATAL ILLNESS HISTORY
Page 132 and 133: 6.17 Did the baby have a swollen st
Page 134 and 135: SECTION 7. HISTORY OF INJURIES/ACCI
Page 136 and 137: 8.7 What were the reasons the baby
Page 138 and 139: 8.15.2 What difficulties did you ha
Page 140 and 141: SECTION 9. DATA ABSTRACTED FROM REC
Page 142: VA Supervisor comments and observat
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