NT-DIP clinical register: Establishing a tool to improve service delivery and quality of care. — ASN Events
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NT-DIP clinical register: Establishing a tool to improve service delivery and quality of care. (#351)

Richa Richa 1 , Cherie Whitbread 1 2 , Christine Connors 3 , Alex Brown 4 5 , Liz Moore 6 , Glynis Dent 7 , Chrissie Inglis 8 , Margie Cotter 6 , Jeremy Oats 3 9 , Louise Maple-Brown 1 2 , on behalf of NT Diabetes in Pregnancy Partnership.
  1. Endocrinology, Royal Darwin Hospital, Rockland Drive, Tiwi, NT, Australia
  2. Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, Australia
  3. Northern Territory Department of Health, Darwin, NT, Australia
  4. South Australian Health and Medical Research Institute,, Adelaide, SA, Australia
  5. School of Population Health, University of South Australia, Adelaide, SA, Australia
  6. Aboriginal Medical Services Alliance Northern Territory, Darwin, NT, Australia
  7. Alice Springs Hospital, Alice Springs, NT, Australia
  8. Healthy Living NT, Darwin, NT, Australia
  9. Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia

Background:
The prevalence of diabetes in pregnancy (DIP) and outcomes for mothers and babies in Northern Territory are not accurately known at this stage. The Northern Territory (NT) DIP clinical register was established in 2011 as an epidemiological and quality assurance tool. We aim to describe the establishment and early use of the register.

Methods:
A working group was formed and steering committee established to represent partners. All pregnant women with any type of DIP in NT are eligible for referral to the register. Referral is by health professionals, using a standard template at the NT health website. Additional data collection is by trained diabetes educators. Data entry is limited to the register coordinators. Clinicians are provided with read-only web based access. Biannual reports are generated to provide quality assurance feedback. The register commenced in 2011 September in Darwin and continues.


Results/Discussions:
There were 953 women referred to the register from September 2011 to end of 2014, 46% of these women were Indigenous. Seventy two percent of rural and remote referrals were Indigenous women. No women have chosen to withdraw from register to date. Fifty three healthcare professionals have web based access to the register; 8 are actively accessing the register in 2015. Reviewing the register in the first 3 years of its establishment has given important insights into the process of register development: establishing a clinical register is possible; funding is required for establishment and to meet ongoing costs. The clinical register is currently used for quality assurance of maternal care and birth outcomes with resultant changes to practice and policy in the NT. Future possible uses of the register include postpartum follow-up and follow-up of children (particularly those of mothers with type2 diabetes in pregnancy). As the women will present again in subsequent pregnancies, it will prove a repository of important information for healthcare professionals.

Conclusion:
The NT-DIP clinical register is still in its nascent stages. Insights gained from establishing the register in NT will help in establishing a similar register in north Queensland, a region with similar challenges in care of pregnant women with diabetes.

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  3. Improving health service delivery for women with diabetes in pregnancy in remote Australia: survey of care in the Northern Territory Diabetes in Pregnancy Partnership. Australian and New Zealand Journal of Obstetrics and Gynaecology 2014; 54: 534-540.
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