The Perinatal Problem Identification Program (PPIP) is a tool to make your perinatal and maternal death audit easier. It does not do the audit for you, but it takes the tedious paperwork out of the process. The moment you enter the basic data, you can instantly do extensive data analysis, and even present your data in graphs and print reports - all with the press of a button.
Let there be no doubt: medical audit (and certainly perinatal and maternal death audit) is not a process that happens without dedicated individuals spending time and effort to make it happen. Furthermore, audit is a futile process if it doesn't 'close the loop' by changing the practice it is auditing. The purpose of audit is not the audit, or the figures, or the reports it generates, but the improvement of practice. If you do not intend to change the way you care for mothers and their babies, PPIP will do nothing for you. If, on the other hand, you want the quality of your care to be weighed and measured because you want to do better, PPIP will provide you with an instrument to make sense of your data without spending hours going through data sheets.
Medical audit includes a number of actions. PPIP makes sense of this process by providing you with three 'levels' of data entry:
PPIP allows you to collect numbers of deliveries, stillbirths, early and late neonatal deaths and maternal deaths. This allows the calculation of different rates (e.g. a perinatal mortality rate) and is used as denominator in various calculations. A selection of 'miscellaneous' data fields allows entry and analysis of specific detail, e.g. mode of delivery.
Each perinatal, neonatal and maternal death is entered in more detail. PPIP allows entry of basic demographic data, after which a primary obstetric cause of death and a final cause of death must be identified. Obviously these causes can then be analyzed in detail.
Lastly, PPIP allows for the identification of specific avoidable factors. These are incidents related to the actions of the mother or health care personnel, or the health care system, which may have altered the outcome of the specific case had it been managed differently. Again, these avoidable factors can be included in data analysis.
In real life different health care providers work together on different levels to provide relevant care. PPIP refers to this structure as a health care pyramid because a broad base of basic health care providers will refer to, or be included in the responsibility of, a next level of care providers. Every higher level usually includes a progressively larger geographic area. PPIP mirrors this structure by allowing the user to create a data pyramid of different 'levels' of units.
When data is entered, it is assigned to a specific data set (care provider). Any data analysis for this particular data set will then include this birth/death. When you do any data analysis of a data set higher in the data pyramid, you can choose whether you want to include only this data set's data, or all the data sets below it as well.
PPIP allows the creation of a data pyramid of up to ten levels.
The real strength of PPIP is the fact that it provides a variety of data analysis functions which can be fine tuned to look at exactly what you want to. A data analysis menu is provided, on which the main groups of data analysis options are provided. Different buttons then provide analysis screens, each with a specific analysis. The user can include or exclude birth weight groups, dates, causes of death, avoidable factors etc. to drill down to the required answer. Various data analyses are presented as colorful graphs, but the data so presented is supplied in tables as well.
The user can display and print unprocessed data as well, i.e. basically the complete data file without any manipulation of the data.
PPIP also allows most data to be exported to Microsoft® Excel™ for any other data manipulation you may require.
If you are serious about perinatal and maternal death audit, and you are looking for a tool to make this process more immediate and less painful, then PPIP is for you. It is supplied to you free of charge, although you have to apply for a licence to use it.