Answers to frequently asked questions from lead reporters about the Each Baby Counts project
Frequently asked questions
How long will it take me to fill in the form?
The average time taken to complete the form is 30 minutes, although it may take you more or less time depending on how familiar you are with the case. As these events are rare, we estimate that an average sized trust/health board will have only a handful of cases to report per year.
I’m struggling to fill in the online form, are there any training materials available?
We have created a number of training materials to aid Lead Reporters in completing reports using the online data collection platform; these are located on the platform itself, under the ‘Training’ tab. We have created a Lead Reporter Training Manual, which outlines how to report a case and includes a step by step guide to making a report. Other resources available include training videos, some of which are currently under development.
What are the details of the Each Baby Counts data set?
The data collection form contains questions related to the adverse event and the results of local serious incident investigations and root-cause analyses. You will also be asked to upload an anonymised copy of the local investigation report.
A hard copy of the data collection form is available under the ‘Training’ tab of the online reporting system. Please feel free to download and print this form if it helps with data collection, but note that it is for internal use only. All data must be submitted via the online platform.
What about babies that are transferred after birth?
Babies that were transferred between institutions after birth, and subsequently die or are diagnosed with a severe brain injury within 7 days, should be reported by the Lead Reporter of the Trust in which the baby was born.
Why do I have to report intrapartum stillbirths and early neonatal deaths? Aren’t these are already reported to MBRRACE?
We appreciate that all perinatal deaths must also be reported to MBRRACE and we have minimised the amount of information that is duplicated in our data collection form. The primary aim of Each Baby Counts is to bring together the results and recommendations of local incident investigations; this information is not captured by MBRRACE or any other organisation at a national level.
We are working with MBRRACE to cross-check our data and ensure that all eligible cases are identified. The MBRRACE system flags potential Each Baby Counts cases on the main ‘Perinatal’ screen, and there is also a downloadable report which gives a list of all potential Each Baby Counts cases.
What will happen once we have submitted our Trust/Health Board’s incident investigation?
The following flow-chart outlines the review process for Each Baby Counts cases:
Where an investigation report contains sufficient information to allow a full assessment, a fully anonymised report will be sent to independent, multidisciplinary reviewers (one midwife and one obstetrician) who will identify and extract themes. A neonatologist reviewer will also review all liveborn babies as standard. This analysis will contribute to the Each Baby Counts annual reports. Reviewers will also be able to flag any cases that require review by another specialist e.g. anaesthetist.
We have introduced stringent anonymisation of the reports so that our independent reviewers will not be able to identify where cases have occurred. To further ensure complete anonymisation we will not allocate cases to reviewers who are located in the same geographic region as the case.
How should I anonymise investigation reports?
The anonymisation requirements are outlined in the Lead Reporter Training Manual and note that investigation reports should not contain any information that would identify patients, staff members, hospitals, units or trusts/health boards. We have produced the following anonymisation guidance to assist Lead Reporters with fully anonymising the reports.
What will happen if I do not complete the reporting of an eligible baby?
When a report has not been completed for a number of months, i.e. some of the questions remain unanswered or a local investigation report has not yet been uploaded, the Each Baby Counts system will send monthly automatic reminder emails to all of the registered Lead Reporters in the relevant trust or health board. If the report remains incomplete for a long period of time, i.e. 6 months from when it was first reported, the relevant Lead Reporters will be personally contacted by a member of the Project Team in order to arrange for completion of the report, this may be via email or telephone.
If the project team receive no response from the Lead Reporter(s) after multiple attempts to contact them, they will contact the Clinical Director of the maternity services (or equivalent) in order to arrange for completion of the outstanding report.
What does it mean when a case is classified as red on the reporting system?
When we classify a case as red, this means we are unable to make any judgements regarding the management of the case or the care provided. This may be due to a lack of a local investigation report, or our independent reviewers may have considered the information uploaded in the local report insufficient to formulate any conclusions about the care provided.
In order to reduce the number of brain injuries and deaths we need to be ensuring that all babies have the thorough review they deserve to ensure we can learn lessons to improve.
What is the timeframe for reporting of cases?
We ask that Lead Reporters should complete Sections 1 and 2 of the online reporting form within 5 working days of the date of the incident using information available in the maternal and/or baby case notes and discharge summary. Section 3 of the form should be completed as soon as the local review has taken place, using information from the incident report.
We are grateful to all Lead Reporters who have helped us to achieve significantly more rapid reporting times since the start of the programme.
Should I report cases where a congenital or chromosomal abnormality has been diagnosed?
We do ask that these cases should be reported unless the baby had a congenital or chromosomal abnormality that led to a planned decision not to monitor the baby in labour using CTG or intermittent auscultation, or to escalate care in the fetal interest. If this decision was made then these cases can be excluded without reporting.
The Each Baby Counts project team undertake a review of all babies submitted who have abnormalities. Any babies who are considered to have a lethal abnormality or where the anomaly is the cause of the outcome will be centrally excluded by the Each Baby Counts team.