Gannon Hannah, Chimhuya Simbarashe, Chimhini Gwendoline, Neal Samuel R, Shaw Liam P, Crehan Caroline, Hull-Bailey Tim, Ferrand Rashida A, Klein Nigel, Sharland Michael, Cortina Borja Mario, Robertson Valerie, Heys Michelle, Fitzgerald Felicity C
Department of Population, Policy & Practice, University College London Great Ormond Street Institute of Child Health, London, UK
Department of Paediatrics and Child Health, University of Zimbabwe, Harare, Zimbabwe.
BMJ Open Qual. 2021 Jan;10(1). doi: 10.1136/bmjoq-2020-001043.
There are 2. 4 million annual neonatal deaths worldwide. Simple, evidence-based interventions such as temperature control could prevent approximately two-thirds of these deaths. However, key problems in implementing these interventions are a lack of newborn-trained healthcare workers and a lack of data collection systems. NeoTree is a digital platform aiming to improve newborn care in low-resource settings through real-time data capture and feedback alongside education and data linkage. This project demonstrates proof of concept of the NeoTree as a real-time data capture tool replacing handwritten clinical paper notes over a 9-month period in a tertiary neonatal unit at Harare Central Hospital, Zimbabwe. We aimed to deliver robust data for monthly mortality and morbidity meetings and to improve turnaround time for blood culture results among other quality improvement indicators. There were 3222 admissions and discharges entered using the NeoTree software with 41 junior doctors and 9 laboratory staff trained over the 9-month period. The NeoTree app was fully integrated into the department for all admission and discharge documentation and the monthly presentations became routine, informing local practice. An essential factor for this success was local buy-in and ownership at each stage of the project development, as was monthly data analysis and presentations allowing us to rapidly troubleshoot emerging issues. However, the laboratory arm of the project was negatively affected by nationwide economic upheaval. Our successes and challenges piloting this digital tool have provided key insights for effective future roll-out in Zimbabwe and other low-income healthcare settings.
全球每年有240万新生儿死亡。诸如温度控制等简单的、基于证据的干预措施可预防约三分之二的此类死亡。然而，实施这些干预措施的关键问题是缺乏经过新生儿护理培训的医护人员以及缺乏数据收集系统。NeoTree是一个数字平台，旨在通过实时数据采集、反馈以及教育和数据链接来改善资源匮乏地区的新生儿护理。该项目展示了NeoTree作为一种实时数据采集工具的概念验证，在津巴布韦哈拉雷中心医院的一家三级新生儿病房中，它在9个月的时间里取代了手写临床纸质记录。我们旨在为每月的死亡率和发病率会议提供可靠的数据，并在其他质量改进指标中缩短血培养结果的周转时间。在9个月的时间里，使用NeoTree软件录入了3222例入院和出院记录，41名初级医生和9名实验室工作人员接受了培训。NeoTree应用程序已完全融入该科室，用于所有入院和出院文件记录，每月的报告也成为常规工作，为当地的医疗实践提供信息。这一成功的一个关键因素是在项目开发的每个阶段都获得了当地的支持和自主权，每月的数据分析和报告也使我们能够迅速解决新出现的问题。然而，该项目的实验室部分受到了全国性经济动荡的负面影响。我们试用这一数字工具的成功经验和挑战为未来在津巴布韦和其他低收入医疗环境中有效推广提供了关键见解。
