NATIONAL NEONATAL SURGICAL BENCHMARKING GROUP

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NATIONAL NEONATAL SURGICAL BENCHMARKING GROUP
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BACKGROUND TO GROUP

• The national neonatal surgical benchmarking group
  is a very innovative and dynamic group dedicated
  to the delivery of high quality care to a very
  unique group of infants. The surgical neonate
  has very complex needs, which are met by a
  regional approach. Often units work in
  isolation, as nursing procedures are unique to
  this group of patients. There is very little
  evidence or research to support such practices,
  and many are based on anecdotal evidence or
  surgeon preference.

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• Group formed in March 2003, and there are
  currently over 13 regional units involved from
  across the British Isles including
• Newcastle Glasgow
• Leeds Manchester
• Hull Sheffield
• Belfast Birmingham
• Cambridge Bristol
• GOS Southampton
• Nottingham

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Group Vision

• Through the process of benchmarking, we aim to
  identify and facilitate the best achievable
  neonatal surgical practice nationally.
  Evaluation and critique of available evidence,
  comparison and sharing of current practices will
  enable the formation of best practice. The use
  of professional consensus in lieu will be used
  when there is a lack of evidence. The group will
  share and compare current practice and ideas.
  Evidence, knowledge and support will be
  encouraged from members of the multi disciplinary
  team to support developing practice.

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What is a benchmark?

• A benchmark is a statement of best practice
  identified using all available evidence, consumer
  views and through professional consensus.

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Clinical practice benchmarking

• Clinical practice benchmarking is a process
  through which best practice is identified and
  continuous improvement pursued through comparison
  and sharing. It is a process of sharing,
  collaboration and supporting with the aim of
  developing practice in order to achieve
  benchmark.
• It is a quality improvement tool which offers
  facilitation, structure and formalisation of how
  best practice is compared, shared and developed.
• Benchmark is quite often aspirational with the
  emphasis on improving practice towards the
  benchmark, and therefore continually improving
  practice and service delivery

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Benchmarking cycle
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Benefits to clinical practice benchmarking
activity

• It provides structure to quality improvement
• Provides a forum for open and honest, supportive
  sharing and collaboration
• Reduces repetition no need to re invent the
  wheel!
• Practitioner led, promotes ownership
• Promotes innovation
• Provides evidence for further resources

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How benchmarks developed

• Identify and agree area to be benchmarked
• Identify all available evidence / research using
  thorough literature review for both quantitative
  and qualitative evidence using
• articles and references
• local unit guidelines, policies and audits
• Comparison of local practices / experiences
• Professional consensus

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• When best practice statement finalised and
  agreed, it is broken down into manageable factors
  and a best practice statement is developed for
  each factor
• Best practice statements must be measurable
  against service / practice delivery which will
  identify good practice and poor practice
• When benchmark complete taken back to local units
  and service / practice is compared to benchmark

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• Initially decision made not to score as felt to
  be a negative factor
• Recently group decided to score benchmarks in
  order to provide more valid and quantifiable
  evidence from benchmarks.
• Once benchmarks scored, individual unit action
  plans developed, which are then fed back to main
  group at following meeting. Experiences are
  shared and compared, good practice shared and
  supported, whilst poorer practices have support
  to improve.
• If necessary national group action plan developed

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• National supportive network in place
• Forum to share, compare and collaborate to
  improve practice
• Providing evidence to base practice on in unique
  group of patients
• Forum in place to carry out research nationally
• Benchmark activity not only benefiting surgical
  neonate, but in some trusts work has led to
  practice development for paediatric directorate
• Article published in Infant journal

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Benchmarks to date

• Management of surgical wounds
• Stoma management
• Gastrostomy management
• Naso gastric feeding management
• Pain management
• Pre operative management

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• ANY QUESTIONS?