Audit of intra-uterine tranfers in the Yorkshire and Humber region Kalwa Munthali Cath Harrison Charlotte Bradford

Aims To determine: Reasons for transfer Clinical reason Capacity – cots v staffing How soon after transfer delivery occurred Distance travelled by mother Compare use of fibronectin and steroids to previous audit data At transfer information to non clinical staff may not be clear. Proforma tries to tease out the reason for tranfer . Uplift in care or capacity In capacity tranfers – we want to look at number of cots available at the referring unit and the number of staff as at the time of the audit this was not clear on referal proforma. - time to delivery -how far they travelled – effect on family life , - has our reporting of fibronectin use and steroid use improved.

Reason given for referral Referrals profile 483 referrals Average time to organise an IUT was 2 hours & 8 minutes Range (1 min – 45 hours ) Reason given for referral N Capacity 278 Uplift in care 203 Repatriation 2 Between september 2014 and august 2015- 483 phone referals were made -from first contact to bed found and confirmed average 2 hours and 8 mins -most referrals were due to units being beyond their capacity

Transfer information 316 single 379 transfers 63 multiple 104 transfer requests withdrawn 21.5 % 314 ODN 65 OORT 483 referals resulted in 379 transfers Most single transfers 63 transfers were multiple involving.....women 104 requests were withdrawn after referal – some stated delivered at unit , bed now availble or deteriorated clinical condition, mother refused travel Compared with march 2017 activity report – 546 referred , 421 transferred (23% withdrawn) 64 OORT Year upto march 2016 504 referred , 389 transferred (23% withdrawn) 72 OORT ODN -operational delivery network OOR - out of region transfer

Transfer information 314 within region distance travelled mean 42.3 miles ( range 4.6 - 92 miles) 65 out of region distance travelled mean 70.35 miles (range 13 - 225 miles) Map of yorkshire 15 420 km squared, a journey from chesterfield to hull 76 miles 122km Calderdale to burnley 12.8 miles 20.6km Longest trip was a transfer to bristol

Delivery outcomes 194 delivery outcomes known 314 in region transfers unknown 20 delivery outcomes known 65 out of region transfers First thing to note is missing data 48% of outcomes are unknown in region. (total % attrition 48% - in and of itself meaningless unless studied patient by patient Out of region outcomes 20 of 65 known , total attrition rate 69% 45 outcomes unknown

Delivery outcomes 46% within 48hrs 18% 2 to 5 days 36% > 5 days As on slide

Delivery outcomes 35 % within 48hrs 15 % 2 – 5 days 50 % > 5 days

End