AH ANNUAL REPORT 2018
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National Clinical Audit<br />
National Cardiac Rhythm<br />
Management Audit (NICOR)<br />
Ulcerative Colitis and Crohn’s<br />
Disease (National UK IBD<br />
(Inflammatory Bowel Disease)<br />
Audit) Biological Therapies<br />
Diabetes (Royal College of<br />
Paediatrics and Child Health<br />
(RCPCH) National Paediatric<br />
Diabetes Audit)<br />
Renal Replacement Therapy<br />
(UK Renal Registry)<br />
Actions<br />
Recommendations and Actions specific to Alder Hey were as follows:<br />
• Address the ongoing challenges with developing or purchasing a Cardiac<br />
Information System that can be used at the point of service to capture data in real<br />
time.<br />
• More input is needed by Clinicians in the capturing/validation of the data.<br />
• More consistency capturing details of any devices used in the operations – i.e.<br />
manufacturer, model and serial number.<br />
• More specific descriptions of procedures done in theatre log books.<br />
• Making submissions by month.<br />
The UK Inflammatory Bowel Disease (IBD) audit has merged with the UK IBD<br />
Registry, moving towards an improved system for data capture and quality<br />
improvement in IBD<br />
On-going collection of our biological therapies data is now through the UK IBD<br />
Registry.<br />
We are now submitting our data to this component of the audit in line with the data<br />
submission deadlines for the IBD Biologics Audit during <strong>2018</strong> and 2019.<br />
Data collection for the audit has improved following our use of the “TWINKLE”<br />
system (diabetes specific data collection software) for data entry. Twinkle enables<br />
automated data capture and reporting for the Best Practice Tariff (BPT).<br />
Actions and recommendations from 2016/2017 audit are as follows;<br />
• We have implemented a new strategy for delivering annual review which includes:<br />
no separate annual review clinics, all annual review delivered by the team between<br />
April to July to increase delivery of care processes, annual review dashboard on<br />
Twinkle software to highlight patients with incomplete annual review.<br />
• Extensive work is ongoing to improve the interface between Meditech 6 (Hospital<br />
system) and Twinkle software as significant areas of activity not captured in the<br />
NPDA (National Paediatric Diabetes Audit) report such as urine ACR (albumin to<br />
creatinine ratio) testing due to lack of transfer of data between the 2 systems.<br />
• Median HbA1c (glycated haemoglobin) above national average – ongoing<br />
program of quality improvement activity to improve outcomes through<br />
improvements in delivering structured education and monthly monitoring of clinic<br />
HbA1c (measuring plasma glucose levels)<br />
• Percentage of patients receiving 4 or more HbA1c measurements is below<br />
national average – patient numbers have increased resulting in insufficient clinic<br />
capacity and high patient to staff ratios. Business case presented to increase<br />
staffing to meet this demand.<br />
• An action plan will be developed to address poor data regarding psychology<br />
support.<br />
• Emergency admission rate is below the national average – this was very good to<br />
see, however we will continue to work on improving this through developing and<br />
delivering a ‘high HbA1c clinic’ and structured education program.<br />
Data are now being submitted through CyberRen. A Renal Information Technology<br />
System specifically for kidney services in the UK. It will enable safe clinical care in<br />
line with clinical governance and good medical practice; access to data for audit<br />
purposes at Trust, Regional and National levels and address Renal Association and<br />
National Service Framework standards. Informatics Merseyside is implementing<br />
CyberREN into all units on behalf of the Cheshire and Merseyside Kidney Care<br />
Network.<br />
Alder Hey Children’s NHS Foundation Trust 87<br />
Annual Report & Accounts 2017/18