District Facility Year amp Month Agenda Welcome and apologies Appointment of meeting secretary Confirmation of previous minutes Do not read minutes ID: 1038057
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1. 6 MONTHLY PERINATAL FACILITY MEETINGDistrict: ___________________Facility: ____________________Year & Month: ____________________
2. AgendaWelcome and apologiesAppointment of meeting secretaryConfirmation of previous minutes (Do not read minutes!)Matters arising -Follow up on previous action plansObstetric current datachallenges & successes, modifiable factors and proposed action plans. Obstetric 6 month review dataRates and trends in mortality, quality and transfer data
3. Agenda7. Neonatal current dataChallenges & successes, modifiable factors and proposed action plans. 8. Neonatal 6 month review dataRates and trends in mortality, quality and transfer dataDiscussionNew action plan
4. Action Plan-FUActionsResponsible person/sTime frameFollow up
5. Obstetric Data: Quality of CareIndicator:Result:Analysis: Significant changes, successes or challengesNo. of postpartum implants No. of post partum IUCD insertions Caesarian delivery (CD) Rate % Caesarian delivery safety score (minimum standards)%<10/12(83%)=failureBANC audit score% Partogram audit score % No. of ESMOE firedrills conducted
6. Obstetric Data: Quality of Care & SupportIndicator:Result:Analysis: Significant changes, successes or challengesNo. of deliveries 28-34 weeks that received 2 steroid doses No. of avoidable steroid misses No. of avoidable HIE cases Regional Hospitals: No. of referring hospitals Regional Hospitals: No. of obstetric outreach visits made District Hospitals: Obstetric regional outreach report received Y / N All Hospitals: District maternity support visit report received Y / N
7. Obstetric Data: Raw DataIndicatorSource DocumentNo. fromSource doc. No. fromDHIS No. fromPPIPVerified TotalAnalysis: Significant changes, successes or challengesNo. of total births No. of live births No. of deliveries between 10-19 yrs. No. of deliveries 28-34 weeks No. of Low Birth weight babies No. of BBAs No. of maternal deaths
8. Obstetric Data: Raw DataIndicatorSource DocumentNo. fromSource doc. No. fromDHIS No. fromPPIPVerified TotalAnalysis: Significant changes, successes or challengesNo. of postpartum haemorrhage No. of perinatal deaths (excl. BBAs) No. of stillbirths-Total Still birthsFSB MSB No. of confirmed HIE’s No. of HIE deaths
9. Obstetric Data: Encephalopathy AnalysisDate of Birth & InitialsMode of deliveryPlace of deliveryGest.WeightSarnat stageDiagnosisOutcomeAnalysis NVDCSInbornOutbornBBA<35weeks>35weeks<2500g2500-3999g>4000g123HIEInfectionCNS/GeneticVascularMetabolicAbstinence syndromeDiedDischargedCase auditedClinical audit scoreAvoidableUnavoidable Totals: ANALYSIS: Significant changes, successes or challenges
10. Maternal TransfersIndicator: No. requestedNo. acceptedDeaths awaiting transferDeaths in transitDeaths at receiving hospital1st 6 mths2nd 6 mths1st 6 mths2nd 6 mths1st 6 mths2nd 6 mths1st 6 mths2nd 6 mths1st 6 mths2nd 6 mthsResult: Actions implemented:
11. Obstetric IndicatorsIndicatorAnnual BaselineTargetPrevious 6mthsCurrent 6mthsCommentiMMRSBRPNMRENMRiNMRNeon. IHMR (Inborn)Neon. IHMR (Outborn)Perinatal Care Index (PCI)
12. Obstetric IndicatorsIndicatorAnnual BaselineTargetPrevious 6mthsCurrent 6mthsCommentPerinatal Care Index (PCI)HIE Rate (Incidence)Case fatality rate (CFR)-HIEInduction of labour success rate (IOL)Caesarean delivery rate (CD)Steroid coverage
13. Previous 6mthsCurrent 6mthsCauses of Maternal Deaths
14. Previous 6mthsTotal No:Current 6mthsTotal No:Avoidable Factors- Maternal
15. Avoidable Factors-MaternalFactorPrev. 6 mths %Current%Patient associated Admin. Med. personnel 1. 2.3.4.5.6.
16. Previous 6mthsCurrent 6mthsPerinatal Deaths
17. Previous 6mthsCurrent 6mthsCauses of Stillbirths 1000-2500g
18. Previous 6mthsTotal No:Current 6mthsTotal No:Avoidable Factors-Stillbirths 1000-2500g
19. Previous 6mthsCurrent 6mthsCauses of Stillbirths >2500g
20. Previous 6mthsTotal No:Current 6mthsTotal No:Avoidable Factors-Stillbirths >2500g
21. Avoidable Factors-HIEFactorPrev. 6 mths %Current%Patient associated Admin. Med. personnel 1. 2.3.4.5.6.
22. Previous 6mthsTotal No:Current 6mthsTotal No:Avoidable Factors-HIE
23. Avoidable Factors-StillbirthsFactorPrev. 6 mths %Current%Patient associated Admin. Med. personnel 1. 2.3.4.5.6.
24. Neonatal Data: Quality of CareInsert Neonatal Dashboard slides….
25. Neonatal Data: SupportIndicator:Result:Analysis: Significant changes, successes or challengesRegional Hospitals: No. of referring hospitals Regional Hospitals: No. of neonatal outreach visits made District Hospitals: Neonatal regional outreach report received Y / N All Hospitals: District neonatal support visit report received Y / N
26. Neonatal Data: Raw DataIndicatorSource DocumentNo. from Source doc. No. fromDHISNo. from PPIPVerified totalAnalysis: Comment on any significant changes, successes or challengesNo. of live births No. of preterm births (<37 weeks) No. of neonatal separations. Nosocomial sepsis separations No. of HIE separations No. of neonatal deaths-total
27. Neonatal Data: Raw DataIndicatorSource DocumentNo. from Source doc. No. fromDHISNo. from PPIPVerified totalAnalysis: Comment on any significant changes, successes or challengesNeonatal Deaths-Inborn Early 0-7 days Late 8-28 days Neonatal Deaths-Out born Early 0-7 days Late 8-28 days No. of preterm deaths No. of neonatal sepsis deaths No. of HIE deaths
28. Neonatal Data: Deaths AnalysisDate of Death & InitialsPlace of deathAge at DeathGest.WeightNeonatal Cause of Death (PPIP)Obstetric Cause of Death (PPIP)Analysis Neonatal UnitKMC LWTheatrePost NatalPaeds wardsOPD/ CasulatyDOAWithin 24hrs 24hrs-7 days 8-28 days29days-11mths<28 weeks28-36 weeks≥37 weeks500-999g1000-2499g≥ 2500gAsphyxiaPrematurityInfectionCong. abnorm.otherSpon. Prem labourHypertensive disorderAntepartum hemorrhageOtherAvoidableUnavoidable Totals: ANALYSIS: (Comment on any significant changes, successes or challenges)
29. Neonatal TransfersIndicator: No. requestedNo. acceptedDeaths awaiting transferDeaths in transitDeaths at receiving hospital1st 6 mths2nd 6 mths1st 6 mths2nd 6 mths1st 6 mths2nd 6 mths1st 6 mths2nd 6 mths1st 6 mths2nd 6 mthsResult: Actions implemented:
30. Neonatal IndicatorsIndicatorAnnual BaselineTargetPrevious 6mthsCurrent 6mthsCommentNeonatal mortality rate (iNMR)Early neonatal mortality rate (ENMR)In hospital neon. mortality rate (IHMR) -InbornIn hospital neon. mortality rate -OutbornCase fatality rate (CFR)-Under 1000gCase fatality rate -1000-2500g
31. Neonatal IndicatorsIndicatorAnnual BaselineTargetPrevious 6mthsCurrent 6mthsCommentCase fatality rate -Above 2500gCase fatality rate-PrematurityNeonatal sepsis rate (incidence)Case fatality rate-Neonatal SepsisBed utilisation rate (BUR)Average length of stay (LOS)
32. Previous 6mthsCurrent 6mthsNeonatal Deaths by Time of Death
33. Previous 6mthsCurrent 6mthsNeonatal Deaths by Weight
34. Previous 6mthsCurrent 6mthsNeonatal Deaths by Place of Death
35. Previous 6mthsCurrent 6mthsNeonatal Cause of Death <1000g
36. Previous 6mthsCurrent 6mthsNeonatal Cause of Death 1000-2500g
37. Previous 6mthsCurrent 6mthsNeonatal Cause of Death >2500
38. Previous 6mthsTotal No:Current 6mthsTotal No:Avoidable Factors-Neonates
39. Avoidable Factors-NeonatesFactorPrev. 6 mths %Current%Patient associated Admin. Med. personnel 1. 2.3.4.5.6.
40. Avoidable Factors by Cause of DeathCurrent 6mthsRankPrematurityAsphyxiaInfection1.2.3.4.5.6.
41. Discussion
42. Action PlanActionsResponsible person/sTime frameFollow up
43. Thank you