Purpose

The Diabetes Pregnancy Audit Project aims to:

• Scope and define the current and future requirements for a national diabetes pregnancy dataset
• Develop a national set of standards
• Prepare for inclusion in the National Diabetes Adult Audit
• Use data to drive service improvement and support the development of networks that can share learning and improve quality

Leadership

The work has been led by a steering group jointly chaired by Dr Nick Lewis-Barned and Dr Helen Murphy.

Approach

The structure and content of the audit was derived after discussions and meetings with key stakeholders. The diabetes and pregnancy audit sets out to answer the following key questions:

• Were the women adequately prepared?
• Were adverse foetal outcomes minimised?
• Were adverse effects on the mother minimised?

The steering group sought agreement of the data item content for the national pilot audit then tested this out against existing three existing diabetes and pregnancy audit collections before piloting with volunteers from the NHS in England. In addition a module to enable the organisational structures required to underpin and effective service to be audited has been developed.

Achievements

• A standardised set of data items was agreed and used in piloting. A list of these items can be found in the data entry form.
• Data from 1381 pregnancies delivered between 1st January 2007 and 31st December 2008 which resulted in a live birth or stillbirth was extracted from three existing regional audits (North West, North East and East Anglia).
• Findings from this work were published in Diabetic Medicine in June 2011 in a paper entitled Development and evaluation of a standardized registry for diabetes in pregnancy using data from the Northern, North West and East Anglia regional audits.
• A prospective pilot audit commenced in July 2010 with six network clusters representing 30 units.
• Information on over 500 pregnancies has been received over a twelve month period and is currently undergoing quality assurance, analysis and review.
• A structured audit questionnaire is being gathered on DiabetesE. To access the site and complete the audit please go to: www.diabetese.net/. Once completed organisations will be able to select the ‘How Do I Compare’ option to compare their answers with other organisations who have completed the audit.

Final steps

• Analysis and evaluation of the validity and easy of collection of the data set items collected by the pinot sites
• Agreement of the final data set
• Formal handover to the National Diabetes Adult Audit team (a consortium of the NHS Information Centre, Diabetes UK and Diabetes Health Intelligence)
• National implementation in March 2012
• Development of pregnancy networks to support quality improvement.