Neonatal Transport Group. Birmingham 2013. Andy Leslie Chair of NTG.
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Transcript of Neonatal Transport Group. Birmingham 2013. Andy Leslie Chair of NTG.
Neonatal Transport Group.Birmingham 2013.
Andy LeslieChair of NTG.
What’s to come
• NTG activity summary.• Data returns. • The year ahead.
NTG Report.
• BAPM memorandum of understanding.• External assessment/accreditation of
teams. • Incident reporting and sharing system. • Air transport. • Membership.
Commissioning
• Scotland – planning new services from April 2014.
• Wales – Provision for N. Wales added• N. Ireland – 24 hour service and PIC links
explored. • England – service specification for
neonatal transport services written for NHS England via Neonatal CRG.
Dataset/IT platform
• Dataset 2012 version unchanged– Some nips & tucks may be needed.
• Tighten some definitions.• Add some filters.
– Comparing quality between services.
• Some progress with an IT spec.
Data 2013
Method
• Email to transport service’s medical and nursing leads requesting activity data from 1.1.13 to 30.6.13
• Brief additional information about each service.
Number of services…
• 2012 – data from 22• 2013 – data from 21
– Kent/Surrey/Sussex reported from 3 services in 2012 and from one service this year.
– N. Wales added.
UK summary data Jan-Jun 2012 & 2013
2012 2013Total transfers 7152 7562Ventilated 1889 (26%) 1961 (26%)
CPAP/high-flow 847 (12%) 906 (12%)
Cooling 247 (3%) 288 (4%)
iNO 99 (1%) 111 (1%)
On inotropes 420 (6%) 447 (6%)
Service Characteristics (n=21)
02468
1012141618
24hrs Dedicatedvehicles
Cot bureau Conf. calls
20122013
Consultants
0
2
4
6
8
10
12
14
All Some Ad-hoc None
• Consultant availability to attend transfers: – Scheduled, all of the
time.– Scheduled, some of
the time– Maybe available, ad-
hoc.– Never available to
attend.
Total Transfers/team, Jan – June 2013
0
100200
300
400500
600
700800
900
Total Transfers/team Jan – June 2012/2013
0
100
200
300
400
500
600
700
800
900
N. Sco
t
W.S
cot
SE Sco
t
CONNECT N Ir
eland
STaRS C
umbr
ia
Newcastl
e
CMNTS Mers
ey
GMNeTS Man
ches
ter
Middles
broug
h
Embrace
Yorks
& H
umbs
CenTre
W M
ids N
TS
ANTS Ang
lia
CHANTS S W
ales
N Wales
Oxford
Thames
Vall
ey
NEST Bris
tol
Lond
on N
TS
KSS Kent
Surrey
Sus
sex
Solent
Penins
ula
Total Transfers 2012
Total Transfers 2013
Increased: 10
Decreased: 8
Average number ventilated transfers/week Jan – June 2012 & 2013
0
2
4
6
8
10
12
14 2012
2013
Number transferred for cooling or assessment for
cooling, Jan – June 2012 & 2013
0
10
20
30
40
50
60 20122013
Total for UK
2012: 247
2013: 288
Number transferred on iNO – Jan – June 2012 & 2013
0
5
10
15
20
25
30
35
40
N. S
cot
W.S
cot
SE
Sco
t
CO
NN
EC
T N
STa
RS
New
cast
le
CM
NTS
GM
NeT
S
Mid
dles
brou
gh
Em
brac
e
Cen
Tre
W M
ids
NTS
AN
TS A
nglia
CH
AN
TS S
N W
ales
Oxf
ord
NE
ST
Bris
tol
Lond
on N
TS
KS
S K
ent
Sol
ent
Pen
insu
la
2012
2013
Total for UK
2012: 99
2013: 111
Time standards
Data on – Time critical (all)– Time critical at base– Referral response time (all)– Uplift transfers performed
% of time critical transfers team mobile within 60 minutes of start of referring call.
% of time critical transfers team mobile within 60 minutes of start of referring call.
0%10%20%30%40%50%60%70%80%90%
100%
13 48 40 39 17 24 13 40 40 17 11 34 68 11
% of time critical transfers team mobile within 60 minutes of start of referring call (all
calls & calls taken at base)
0102030405060708090
100 All
At base
Team arrived with the patient within 3.5 hours of the start of the referring call
(Intensive care; uplift) (n=)
• Problem with inclusion of infants for elective or semi-elective procedures (e.g. PDA ligation).
Team arrived with the patient within 3.5 hours of the start of the referring call
(Intensive care; uplift) (%)
0102030405060708090
100
N. Sco
t
W.S
cot
SE Sco
t
CONNECT N Ir
eland
STaRS C
umbri
a
Newca
stle
CMNTS Mer
sey
GMNeTS M
anch
ester
Middles
brou
gh
Embrac
e Yor
ks &
Hum
bs
CenTr
e
W M
ids N
TS
ANTS Ang
lia
CHANTS S
Wale
s
Oxford
Thames
Vall
ey
Lond
on N
TS
KSS Ken
t Surr
ey S
usse
x
Solent
Penins
ula 25 14 33 24 17 67 46 98 47 169 145 136 202 61 25 325 160 50 36
Neonatal Transport Services transfer at least 95% of patients requiring transfer for uplift within its
defined catchment area. (%)
• Counting what we don’t do is difficult.
Neonatal Transport Services transfer at least 95% of patients requiring transfer for uplift within its
defined catchment area. (%)
Neonatal Transport Services transfer at least 95% of patients requiring transfer for uplift within its
defined catchment area. (%)
50556065707580859095
100
N. Sco
t
W.S
cot
SE Sco
t
STaRS C
umbri
a
Newca
stle
CMNTS Mer
sey
GMNeTS M
anch
ester
Middles
brou
gh
Embrac
e Yor
ks &
Hum
bs
CenTr
e
W M
ids N
TS
ANTS Ang
lia
CHANTS S
Wale
s
Oxford
Thames
Vall
ey
Lond
on N
TS
KSS Ken
t Surr
ey S
usse
x
Solent
Penins
ula 71 65 61 44 111 162 141 54 318 256 237 290 84 134 396 259 87 66
Over-ventilation
% of uplift and resources/capacity transfers, ventilated in transit with pCO2 <4 kPa on the gas measurement on
completion of transfer, UK
% of uplift and resources/capacity transfers, ventilated in transit with pCO2 <4 kPa on the gas measurement on
completion of transfer, UK
•Note that not all infants had pCO2 available post-transfer.
% of uplift and resources/capacity transfers, ventilated in transit with pCO2 <4 kPa on the gas measurement on
completion of transfer, UK
Alln=
pCO2 <4 kPa
n=
pCO2 <4 kPa
%
All uplift & resource
1355 118 9
Uplift 1273 112 9
Resource 82 6 7
% pCO2 <4 kPa on completion , per service.Jan – June 2013.
0%
5%
10%
15%
20%
25%
30%
N. Sco
t
W.S
cot
SE Sco
t
CONNECT N Ir
eland
STaRS C
umbri
a
Newca
stle
CMNTS Mer
sey
GMNeTS M
anch
ester
Middles
brou
gh
Embrac
e Yor
ks &
Hum
bs
CenTr
e
W M
ids N
TS
ANTS Ang
lia
CHANTS S
Wale
s
Oxford
Thames
Vall
ey
NEST Bris
tol
Lond
on N
TS
KSS Ken
t Surr
ey S
usse
x
Solent
Penins
ula
17 31 34 10 13 60 32 79 33 106 133 17 153 50 53 65 246 141 41 31
% pCO2 <4 kPa on completion , per service.Jan – June 2013.
0%
5%
10%
15%
20%
25%
30%
N. Sco
t
W.S
cot
SE Sco
t
CONNECT N Ire
land
STaRS C
umbri
a
Newca
stle
CMNTS Mers
ey
GMNeTS M
anch
ester
Middles
broug
h
Embrace
York
s & H
umbs
CenTre
W M
ids N
TS
ANTS Ang
lia
CHANTS S W
ales
Oxford
Thames
Vall
ey
NEST Bris
tol
Lond
on N
TS
KSS Ken
t Surr
ey S
usse
x
Solent
Penins
ula 17 31 34 10 13 60 32 79 33 106 133 17 153 50 53 65 246 141 41 31
*
*
* *
*
% pCO2 <4 kPa on completion , per service.Jan – June 2013.
0%
5%
10%
15%
20%
25%
30%
N. Sco
t
W.S
cot
SE Sco
t
CONNECT N Ire
land
STaRS C
umbri
a
Newca
stle
CMNTS Mers
ey
GMNeTS M
anch
ester
Middles
broug
h
Embrace
York
s & H
umbs
CenTre
W M
ids N
TS
ANTS Ang
lia
CHANTS S W
ales
Oxford
Thames
Vall
ey
NEST Bris
tol
Lond
on N
TS
KSS Ken
t Surr
ey S
usse
x
Solent
Penins
ula 17 31 34 10 13 60 32 79 33 106 133 17 153 50 53 65 246 141 41 31
*
*
* *
*BP
StefFab BLBP BP BP
Stef
BPStef
Fab
BP
BP
BP
Stef
Stef
BP
Stef
Fab
BP
Stef
Stef
Stef
BL
Stef
Fab
BP
% pCO2 <4 kPa , per service, ETCO2.
0%
5%
10%
15%
20%
25%
30%
N. Sco
t
W.S
cot
SE Sco
t
CONNECT N Ire
land
STaRS C
umbri
a
Newca
stle
CMNTS Mers
ey
GMNeTS M
anch
ester
Middles
broug
h
Embrace
York
s & H
umbs
CenTre
W M
ids N
TS
ANTS Ang
lia
CHANTS S W
ales
Oxford
Thames
Vall
ey
NEST Bris
tol
Lond
on N
TS
KSS Ken
t Surr
ey S
usse
x
Solent
Penins
ula 17 31 34 10 13 60 32 79 33 106 133 17 153 50 53 65 246 141 41 31
*
*
* *
*
No end-tidal
Data, summary
• Data-rich environment. • Tipping point.• There’s lots more we can do!• Measure what’s meaningful, not just
what’s measureable.
NTG
• Embrace the quality agenda. – Data – hypothesis generation & shared
projects.– Incident sharing.– Promoting patient-focussed best practice.– Benchmarking.
• Support the profession.
Time critical transfers, all, n= Jan – June 2012 & 2013
0
10
20
30
40
50
60
70
80
>60 mins
<60 mins
Team arrived with the patient within 3.5 hours of the start of the referring call
(Intensive care; uplift) (n=)
0
50
100
150
200
250
300
350
N. Sco
t
W.S
cot
SE Sco
t
CONNECT N Ir
eland
STaRS C
umbr
ia
Newcastl
e
CMNTS Mers
ey
GMNeTS Man
ches
ter
Middles
broug
h
Embrace
Yorks
& H
umbs
CenTre
W M
ids N
TS
ANTS Ang
lia
CHANTS S W
ales
Oxford
Thames
Vall
ey
Lond
on N
TS
KSS Kent
Surrey
Sus
sex
Solent
Penins
ula
>3.5 hrs
<3.5 hrs
Neonatal Transport Services transfer at least 95% of patients requiring transfer for uplift within its
defined catchment area. (n=)
050
100150200250300350400450
N. Sco
t
W.S
cot
SE Sco
t
STaRS Cumbri
a
Newca
stle
CMNTS Mers
ey
GMNeTS M
anches
ter
Middles
brough
Embrace
York
s & H
umbs
CenTre
W M
ids NTS
ANTS Angli
a
CHANTS S W
ales
Oxford
Thames
Vall
ey
Lond
on NTS
KSS Kent
Surrey S
usse
x
Solent
Penins
ula
Done by other
Done by team