By Mohamed Reda Bassiouny, MD, MHPE Professor of Pediatrics/Neonatology Mansoura University Amr ElShahed, MD, DHPE Lecturer of Pediatrics Mansoura University, Consultant Neonatologist
Funded by European Union TEMPUS
In Egypt, there is a reduction in neonatal mortality and an increase in the number of survivors of lowbirth-weight babies over the last decade. The primary cause of death of a baby is not identified in the patient record. To improve the quality of care, the medical community needs to know how to perform patientoriented research in neonates.
To train Pediatricians on electronic registration of neonatal health records To develop the skills of academic staff and clinicians as regard to education and innovative research capabilities to achieve improved outcomes through the improved quality of delivery of health care. To establish and maintain a neonatal database that will allow comparison between participating hospitals To study the mortality and morbidity of high risk infants admitted to the participating neonatal care units in EGYPT.
To be a basis for policy planning and resource allocation at a departmental, national and regional level. To be a basis for quality improvement and management at a departmental, national and regional level. To join other international neonatal networks, which will provide the ability to benchmark healthcare in Egypt against international standards.
Setting Up Workshop EGNN operational Policy workshop Data definition workshop Orientation Course Using the network
Training Courses Leadership/Team management Quality Control Research Methods Grant application Research Ethics Evidenced Based Medicine Auditing
Mohamed Reda Bassiouny, MD, MHPE Professor of Pediatrics and Neonatology Mansoura University
European Co-beneficiaries 1. Spain: Cruces University 2. UK: Liverpool University 3. Germany: Ulm University Egyptian Co-beneficiaries 1. Al Azhar University 2. Ain Shams University 3. Alexandria University 4. Tanta University Individual Experts Prof. Nahed Fahmy - Cairo University/MOH Prof. Hesham Fathy - Suez Canal University
Alexandria University Professor Abdel-HalimBadr-El-Din Ain Shams University Professor Mohamed Sami El Shimi AL Azhar University, Faculty of Medicine for Girls Professor Safaa EL Meneza Tanta University Professor Mohamed Rowisha
Site Investigator EGNN Data Center Hard Copy Data Entry Patients Registry E-Data Entry
Site Investigators Professor Abdel-HalimBadr-El-Din Alexandria University Professor Mohamed Reda Bassiouny Mansoura University Professor Hesham Awad : Ain Shams University Professor Safaa EL Meneza - AL Azhar University, Faculty of Medicine for Girls Professor Addelrahman AlMashad - Tanta University Amal ElSaid Mansoura Insurance Hospital
Dramatic changes in the field of neonatology: Surfactant therapy New modes of assisted ventilation Other new technologies e.g. Nitric Oxide, ECMO Intervention e.g. brain cooling All these have changed the way neonatology is practiced.
It was not always clear what was the "best" practice. Evidence: the wide variations in outcome and process indicators in the network database, i.e. NICUs are delivering care to newborns differently and are getting different outcomes.
There is increased interest in evaluation of the neonatal care due to: The great variation among physicians and hospitals in neonatal practice and patient outcomes The growing pressure to increase the costeffectiveness of medical care
Health professionals must understand how to evaluate their own performance and how their performance will be evaluated by others.
The era of assessment and accountability
Data Center NICU Mansoura University base station NICU NICU NICU NICU NICU NICU NICU NICU NICU NICU USB Modem Laptops
Egyptian Partner NICU NICU base station NICU 9 NICUs/ Partners Our Target: 50 NICUs NICU NICU NICU NICU NICU NICU NICU
A neonatal network is a collaboration involving more than one clinical site where a common protocol is used for randomized trials, observational studies and Quality improvement projects. The members share their data that has been defined before
using the Egyptian Neonatal Network (EGNN) web Every Egyptian University in the project will be committed to recruit 9 centers from nearby hospitals to join EGNN.
No patient Identifier export to Data management center Only Network Random Number Medical record number is seen in the participating center only No names Each Site investigator has an access to his center data only
Regular reports will be sent to the participating centers. the annual meeting. involvement of the top managers in the project s design and life via interviews, conferences etc.
It helps member centers to view and create statistical reports online View statistical reports on all collected measures Export information to PDF or Excel formats Download Network database summaries
Create databases Conduct outcomes research Conduct clinical trials Conduct collaborative quality improvement
The Vermont Oxford Network The National Institute of Child Health and Human Development The California Perinatal Quality Care Collaborative The Canadian Neonatal Network European Neonatal Network Swiss Neonatal Network Australian and New-Zealand Neonatal Network Neonatal Research Network Japan Israel Neonatal Network
Reports with feedback about your center s performance. Opportunities to participate in collaborative quality improvement projects. Research projects and clinical trials. The Network s newsletter and notifications of annual meetings.
PBPs direct what is done, not how it is done. It can take years to detail all the multiple layers to co-ordinate processes in any unit.
PREVENTION OF NOSOCOMIAL INFECTION Handwashing Nutrition Skin care Improved diagnosis Respiratory care Vascular access Unit culture
Good decisions Good information Raw Facts (data) Database
Database is a collection of records or information which are stored in a computer in a systematic way.
Neonatologists should not be expected to become experts in electronic databases and evaluation methods.
Hospital Information Systems Where all of a patient's medical reports, lab. results, and images are electronically available to clinicians instantaneously wherever they are.
Database use A looking glass
Vital Statistics. Hospital Information Systems. Claims Data. Neonatal Databases and Networks.
Primary databases for neonatal patients can be: developed locally acquired commercially as part of a multi-hospital neonatal network.
Collection of data using the standard definitions and procedures adhered to by all members of that network.
Data are necessary but not sufficient NICU teams need Motivation Training Skills Tools and Resources
DRG systems are used for: case-mix trending utilization management quality improvement comparative reporting prospective payment price negotiations.
The International Statistical Classification of Diseases and Related Health Problems (ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and causes of injury.
Every health condition can be assigned to a unique category and given a code. Such categories can include a set of similar diseases Published by the WHO. Used world-wide for morbidity and mortality statistics and automated decision support. Revised periodically and is currently in its tenth edition.
Arab Region has a high rate of population movement in between Arab countries. High rate of inbreeding Similar habits and traditions
to share this database with NICUs across our region to be a base for constructing an Egyptian Neonatal Network. Join other international neonatal network.
They has been favored by the logic of mutual interest for all the partners who are able to conduct leading multi-disciplinary, collaborative research dedicated to the improvement of neonatal health and health care to international standards.
Euroneonet Ministry of Health Two big NGOs: Egyptian Association of Neonatology Egyptian society of premature and neonatal care All the National Consortium are active board members in both societies.
Voluntary work Fund: Ministries of Health WHO Unicef International projects concerned with Neonatal Care