Benchmarking care for very low birthweight infants in Ireland and Northern Ireland
- 1Department of Neonatology, Cork University Maternity Hospital, Cork, Ireland
- 2Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
- 3Department of Child Health, Queen’s University, Belfast, Northern Ireland, UK
- Correspondence to Dr B P Murphy, Department of Neonatology, Cork University Maternity Hospital, Wilton, Cork, Ireland; brendanpaul.murphy{at}hse.ie
- Accepted 20 August 2009
- Published Online First 31 August 2009
Abstract
Background: Benchmarking is that process through which best practice is identified and continuous quality improvement pursued through comparison and sharing. The Vermont Oxford Neonatal Network (VON) is the largest international external reference centre for very low birth weight (VLBW) infants. This report from 2004–7 compares survival and morbidity throughout Ireland and benchmarks these results against VON.
Methods: A standardised VON database for VLBW infants was created in 14 participating centres across Ireland and Northern Ireland.
Results: Data on 716 babies were submitted in 2004, increasing to 796 babies in 2007, with centres caring for from 10 to 120 VLBW infants per year. In 2007, mortality rates in VLBW infants varied from 4% to 19%. Standardised mortality ratios indicate that the number of deaths observed was not significantly different from the number expected, based on the characteristics of infants treated. There was no difference in the incidence of severe intraventricular haemorrhage between all-Ireland and VON groups (5% vs 6%, respectively). All-Ireland rates for chronic lung disease (CLD; 15–21%) remained lower than rates seen in the VON group (24–28%). The rates of late onset nosocomial infection in the all-Ireland group (25–26%) remained double those in the VON group (12–13%).
Discussion: This is the first all-Ireland international benchmarking report in any medical specialty. Survival, severe intraventricular haemorrhage and CLD compare favourably with international standards, but rates of nosocomial infection in neonatal units are concerning. Benchmarking clinical outcomes is critical for quality improvement and informing decisions concerning neonatal intensive care service provision.
Footnotes
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Funding In Northern Ireland, the Department of Health, Social Services and Public Safety provided full funding for the Northern Ireland part of the project. The southern part of this project was initially funded by the Department of Health and Children for a pilot period of 3 years. It now works in partnership with the National Perinatal Epidemiology Centre at Cork University Maternity Hospital.
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Competing interests None.
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Provenance and Peer review Not commissioned; externally peer reviewed.
