Maternity Safety Thermometer: East Cheshire’s Maternity Quality Dashboard and developing a deeper understanding of quality of care
East Cheshire are a community and acute trust serving a large population of over 470,000 people with a vision to deliver the best care in the right place. They have over 3000 staff who work across their community settings and three hospital sites.
The Macclesfield Maternity Unit provides specialist Obstetrics and Midwifery-led care in 5 labour rooms, handling just under 2000 deliveries a year.
Speciality care data: From Classic to Next Generation Safety Thermometer
East Cheshire had implemented NHS Safety Thermometer “Classic” across the broader Trust, which allows teams to measure harm and the proportion of patients that are ‘harm free’ from pressure ulcers, falls, catheter UTIs and venous thromboembolism. Although Maternity were not involved in the Trust’s larger roll-out of the Safety Thermometer Classic, they did capture VTE data, and were inspired by the Safety Thermometer to start looking into harm in Maternity and raising awareness.
When the Maternity Safety Thermometer was released, the Trust saw this as an opportunity for a tool to monitor safety. The Maternity Safety Thermometer measures harm from Perineal and/or Abdominal Trauma, Post-Partum Haemorrhage, Infection, Separation from Baby and Psychological Safety. In addition it also identifies babies with an Apgar of less than Seven at Five Minutes and/or those who are admitted to a Neonatal Unit.
Using the Maternity Safety Thermometer Data
Prior to adopting the Maternity Safety Thermometer, East Cheshire Maternity was already collecting safety and quality of care data from a number of sources, for example RADAR, Friends and Family, Infection Control reports, and patient feedback.
Initially, each of these measures were taken, submitted, reported and acted upon individually.
Inspiration from clinical dashboards
Seeing the benefits of data visualisation and “at a glance” status from the Red/Amber/Green-based maternity clinical dashboard and performance dashboard that East Cheshire already had in place, Maternity Matron Amanda Lucas sought to apply this approach to patient safety. Bringing together the various data that Maternity were monitoring into one place in a new ‘ECT Maternity Quality Dashboard’, Amanda applied the successful Red/Amber/Green system to rate each figure against its target goal, developing a powerful tool for visualising and triangulating data on safety and quality of care.
Triangulation of Data for in-depth understanding of quality of care
The ECT Maternity Quality Dashboard brings together the data collected from the Maternity Safety Thermometer with Infection Control, Families and Friends and Patient perception perspectives, providing the Maternity unit with the opportunity to triangulate measures and extract more meaningful information from the data.
This triangulation is especially beneficial when there are fewer patients present and the data sample size is a low one, meaning that one instance of harm, for example, may represent a large figure when calculated as a percentage. Monitoring these data alongside other indicators of safety and quality which provide a wider context can give a much greater depth of understanding and meaning to the data sets.
The Maternity Quality Dashboard
This dashboard data is available to staff, as key stakeholders, and every measure is seen by the Trust as an opportunity for improvement.
The simple Red/Amber/Green colour coded status approach has proven to be effective in easily identifying areas where improvements are required or further, more in-depth, investigation is needed. It gives an instant visual picture of safety and quality across the board, highlighting any areas of concern or opportunities for development or stretch goals, and making it easier to spot patterns in and across the data presented in the dashboard. Recognising themes and patterns here can help to prompt and direct training, clinical audits or improvement programmes going forwards.
Transparency and patient information
East Cheshire also use their Maternity Safety Thermometer data in patient information posters, alongside other measures of safety, and patient perception and feedback about their care. These posters are displayed as part of the Trust’s public-facing “How are we doing?” boards on the unit, and are a great example of ‘open and honest care’ in action.
East Cheshire NHS Trust’s Maternity Quality Dashboard is a fantastic example of how measures from the Maternity Safety Thermometer can be integrated into local systems and used alongside other national and local measures to build a rich picture of quality and safety in a care environment.
Have you developed a unique or innovative use or adaptation of Safety Thermometer data? Contact us to share your story and inspire other Trusts.