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National Clinical Audit Actions

National Cardiac Rhythm Recommendations and Actions specific to Alder Hey were as follows:
Management Audit (NICOR)
• Address the ongoing challenges with developing or purchasing a Cardiac
Information System that can be used at the point of service to capture data in real
time.
• More input is needed by Clinicians in the capturing/validation of the data.
• More consistency capturing details of any devices used in the operations – i.e.
manufacturer, model and serial number.
• More specific descriptions of procedures done in theatre log books.
• Making submissions by month.

Ulcerative Colitis and Crohn’s The UK Inflammatory Bowel Disease (IBD) audit has merged with the UK IBD
Disease (National UK IBD Registry, moving towards an improved system for data capture and quality
(Inflammatory Bowel Disease) improvement in IBD
Audit) Biological Therapies On-going collection of our biological therapies data is now through the UK IBD
Registry.
We are now submitting our data to this component of the audit in line with the data
submission deadlines for the IBD Biologics Audit during 2018 and 2019.

Diabetes (Royal College of Data collection for the audit has improved following our use of the “TWINKLE”
Paediatrics and Child Health system (diabetes specific data collection software) for data entry. Twinkle enables
(RCPCH) National Paediatric automated data capture and reporting for the Best Practice Tariff (BPT).
Diabetes Audit) Actions and recommendations from 2016/2017 audit are as follows;
• We have implemented a new strategy for delivering annual review which includes:
no separate annual review clinics, all annual review delivered by the team between
April to July to increase delivery of care processes, annual review dashboard on
Twinkle software to highlight patients with incomplete annual review.
• Extensive work is ongoing to improve the interface between Meditech 6 (Hospital
system) and Twinkle software as significant areas of activity not captured in the
NPDA (National Paediatric Diabetes Audit) report such as urine ACR (albumin to
creatinine ratio) testing due to lack of transfer of data between the 2 systems.
• Median HbA1c (glycated haemoglobin) above national average – ongoing
program of quality improvement activity to improve outcomes through
improvements in delivering structured education and monthly monitoring of clinic
HbA1c (measuring plasma glucose levels)
• Percentage of patients receiving 4 or more HbA1c measurements is below
national average – patient numbers have increased resulting in insufficient clinic
capacity and high patient to staff ratios. Business case presented to increase
staffing to meet this demand.
• An action plan will be developed to address poor data regarding psychology
support.
• Emergency admission rate is below the national average – this was very good to
see, however we will continue to work on improving this through developing and
delivering a ‘high HbA1c clinic’ and structured education program.

Renal Replacement Therapy Data are now being submitted through CyberRen. A Renal Information Technology
(UK Renal Registry) System specifically for kidney services in the UK. It will enable safe clinical care in
line with clinical governance and good medical practice; access to data for audit
purposes at Trust, Regional and National levels and address Renal Association and
National Service Framework standards. Informatics Merseyside is implementing
CyberREN into all units on behalf of the Cheshire and Merseyside Kidney Care
Network.

Alder Hey Children’s NHS Foundation Trust 87 Annual Report & Accounts 2017/18