National Pregnancy in Diabetes Audit Guidance for using the summary data tables in the Clinical Audit Platform

Summary tables (sometimes called management reports) were introduced to the NPID audit to increase local monitoring of service performance. The summary tables allow users to check on their performance as soon as their completed records are entered. This will enable participants to regularly check and improve on their audit results throughout the year and make changes to their practices without waiting for the annual report. The tables will reflect ‘live’ data entered and therefore encourage the prompt entry of patient data to obtain instant results.

The tables will act as an important quality improvement tool and will empower users to ask questions of their results and rectify anomalies earlier than was previously allowable.

The summary tables aim allow users to achieve a personalised dataset for local use as and when they need it.

You can use these tables for local monitoring of the NPID data and to present up to date results within your trust. The tables can be taken to performance and quality meetings or any other relevant internal meeting were audit participation and results are discussed. They can be used as a tool to aid with local audits or to compare results throughout the course of an audit cycle.

In the Clinical Audit Platform (CAP) National Pregnancy in Diabetes home page go to reporting then select summary data tables from the menu and enter the date range required for analysis. This will bring up a number of tables which include the patient data for those with a pregnancy end date within the date range chosen.

These tables only include those patients that have a completed record in the Clinical Audit Platform (CAP). A completed episode is classed as a record that includes the pregnancy end date within the data entered.

Table 1 patient demographics

This table shows the number of patients entered for your site (all pregnancies in date range) and their diabetes type.

Tables 2, 3 and 4

These tables show the number of patients separated firstly by diabetes type and secondly by BMI and age.

Tables 5 - Use of folic acid prior to LMP all types

This table shows the use of Folic Acid prior to LMP (all pregnancies in date range). This table can be used to highlight the number of women in your audit sample that were taking folic acid prior to LMP. This can often be before the woman comes into contact your service, however it could be useful to see if any improvement can be made through better communication with primary care or by focusing on certain age groups. Any records where usage is not known highlight a data quality issue which could possibly be resolved by checking a patient’s records and updating the data base.

Table 6

This table shows the Use of folic acid prior to LMP (Dosage) This shows the number of patients from Table 5 where usage was known and highlights the dosage of folic acid used. Displayed percentages may not add to 100 because the denominator is ‘all’ pregnancies, not just those where dosage is known.

Tables 7, 8, 9 use of folic acid prior to MLP by diabetes type

These tables show the dosage of those known to have taken folic acid (table 5) separated by diabetes type. Displayed percentages may not add to 100 because the denominator is all pregnancies, not just those whose dosage is known.

Table 10 fist contact all types

This table shows the first contact the patient had with a health professional at 10 weeks or under. Where there are low numbers in this bracket it could highlight that improvement is required and local practice could be updated to facilitate these patients earlier (where possible) such as direct early access to the ante-natal team. Any pregnancies where first contact was later than 10 weeks, or where the first contact date has not been entered, are not listed but are included in the “total pregnancies”. Therefore percentages may not add to 100.

Tables 11, 12, 13 by diabetes type

These tables show the number of patients who were seen on or before 10 weeks (Table 10) separated by diabetes type.

Any pregnancies where first contact was later than 10 weeks, or where the first contact date has not been entered, are not listed but are included in the “total pregnancies”. Therefore percentages may not add to 100.

Table 14 – HBA1c all types

This table shows the number of patients whose first HBA1c reading was taken before 12 weeks. The second line shows the patients that have just missed the 12-week recommended guideline for first HBA1c taken in the first trimester, however in the annual report they would not be shown as an outlier. In the NPID annual report, we report on first trimester HBA1c, which is taken at less than 13 weeks, so this calculation is slightly different.

Tables 15, 16 and 17 – HBA1c by diabetes type

These tables show the HBA1c readings of those patients that were seen less than 12 weeks from table 14. Pregnancies where First HBA1c reading date less than 12 weeks but where no reading is recorded are included in the first row but not the break down.

Table 18 – Diabetes treatment regime(s) at 1st day of LMP

This table can be used to highlight the diabetes treatment regimens/medications of the patients in your audit sample.

Please note that if a woman in your care is on more than one of the listed medications they will all be counted within the table. This means the number of medications listed may be more than your total number of completed entries.

Table 19 ACE Inhibitors

This table shows patients who were recorded as taking ACE Inhibitors / ARB on 1st Day of LMP.

Table 20 Statins

This table shows patients who were recorded as taking Statins on 1st Day of LMP.

Table 21 – Last HBA1c Reading all types

This table shows the number of patients whose last HBA1c reading was taken after 24 weeks of pregnancy as recommended. The second line shows the patients that have not had a reading taken at the >24-week recommended guideline for HBA1c taken in the last trimester.

Tables 21, 22 and 23 – last HBA1c Reading by diabetes type

These tables show the women whose HBA1c was taken after 24 weeks split by diabetes type.

Table 24 – Pregnancy Outcomes by diabetes types

This table shows pregnancy outcomes by Diabetes types including Live(birth), Still (birth), termination and miscarriage.

Table 25 – Congenital Anomalies

This table shows the number of Congenital Anomalies in the Live & Still Births listed in table 24.

Table 26 – Requiring Neonatal Care

This table shows the number of Live Births that required Neonatal Care.

The tables can be printed out for use locally, however they will not be in the same format as shown on the online platform.

There are a few options which you can use to print the tables that are listed below.

1. The print button on the page produces a printout of all the tables but cuts out any footnotes. The tables print without a border.

2. The print function in the browser keeps the footnotes but you will need to print each tab separately.

3. After running the report, use ‘Ctrl’+’a’ to ‘select all’ and copy (‘Ctrl’+’c’) and paste (‘Ctrl’+’v’) in to Excel. This may be an easier option but please note that the tables may need some further manipulation in Excel for them to be presentable.

For further information on the summary tables or general enquiries, including queries regarding data collection and submission, please contact the NPID Team at [email protected] or 0300 303 5678.