Maternity dashboard.

List of contents.

1. abbreviations
2. introduction
3. suggested reading
4. key facts
5.     what is the maternity dashboard?
6.     when was it introduced?
7.     how does it work?

Abbreviations.

CNST:    Clinical Negligence Scheme for Trusts see also MCQ12, question 15.

RCOG:    Royal College of Obstetricians and Gynaecologists.

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Introduction.

This should be too specialist and technical for the DRCOG exam.

But could be a MRCOG viva.

Few Trusts seem to use it, so most trainees, even those in the UK, have no experience of it.

And it is not a CNST requirement.

People working in other countries may not even have heard of it!

So it would be a killer viva station.

And it is also the sort of term that might usefully be tossed into an essay for an extra mark.

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Suggested reading.

MRCOG candidates would be wise to read the RCOG document, which dates from 2008.

It is not the most easily digested article ever written, so read this webpage first.

I am arrogant enough to think that this will help with the RCOG's effort!

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Key facts.

This is a simple tool to help with clinical governance and risk management.

It provides a visual display of things that are going well and those that need attention.

The use of the word "dashboard" is to make a comparison with your car.

As you drive, the various gauges give your the speed, revs per minute, oil temperature etc.

In many cases the gauge has a red band for excessive speed, dangerous temperatures etc.

The maternity dashboard does something similar.

You construct a table with the key things you want to monitor.

The table highlights in red those things that need urgent attention.

And the things you need to note which are in amber.

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What is the maternity dashboard?

It is a simple system for monitoring performance against a number of key indicators.

It consists of a table of all the things you deem important.

You monitor them month by month.

You might look at the numbers of women booked for a particular month.

If there are too many, you need to stop further bookings.

If there are too many Caesarean sections in a particular month, you need to know the reason why.

It could be that you have new junior staff who need more support.

Things that are OK are coloured green.

Things needing attention are coloured amber.

Things needing urgent action are coloured red.

When you look at the table, most of the cells will be coloured green.

So, you can very quickly spot the ones that need attention or urgent action.

This is illustrated in the section: "How does it work?"

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When was it introduced?

The College document is dated 2008.

It describes a working system, so it must have been around longer.

But I think all you need to know that it is a recent RCOG document.

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How does the maternity dashboard work?

You construct a table with the key things you want to monitor.

For example, you might want to monitor staff sickness rates.

Very high rates can point to staff stress: overwork, unmet training needs, management problems etc.

You would get advice from your personnel department, look for any national sources etc. and decide what levels would be appropriate for you.

You need to have "goals": e.g. that staff sickness rates should be < 5%.

Key buzzwords are "parameter and benchmark".

"Parameter" has very specific meanings in mathematics, physics etc.

Its use has become much less specific in common usage.

The RCOG's usage falls into this sloppy category:

    "In interpreting the data from the Maternity Dashboard

        it is paramount to take a ‘snapshot’ view,

        as well as to note trends in the various parameters."

In this and other examples, the RCOG uses it as equivalent to key standard or indicator.

So this is the usage you will need to adopt.

In this case, the parameter is the staff sickness rate.

My Oxford English Dictionary defines "benchmark" as: "a point of reference or standard".

It goes on to explain that surveyors use a modified arrow shape to denote a point that has been surveyed.

Presumably you can then use it to survey other points.

You decide that rates up to 5% are OK.

And rates > 10 % need urgent action.

So, your benchmarks are 5% for highlighting when it merits your attention.

And 10% for urgent attention.

You might get the following results for the first 6 months of the year.

You can see at a glance that the figures in May needed urgent action; those for March and June needed attention.

The figures would be updated monthly, so that those presented at the end of May would be:

You will note that the May figures need action and act appropriately.

You might have similar figures for third degree tears.

You might have monthly figures of 3 for attention and 5 for urgent action.

When the monthly figures are produced at the end of August, you would have the following

You will already have dealt with the amber and red "flags" for the preceding months.

So you will only need to direct your attention to the four 3^rd.0 tears.

The full table for the end of August would include a whole load of other key indicators.

And might look something like this:

You now have all your key indicators in an easy display mode.

You can see what needs to be done "at a glance".

At the end of August you need urgent action on Key Indicator Number 4.

And you need to pay attention to the number of 3^rd.0 tears and to Key Indicator Number 9.

But at the end of April there had been nothing to cause concern.

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