Increasing data completeness for two year follow up data - a case study for NNAP

The following case study was included in the 2016 National Neonatal Audit Programme annual report to highlight how some neonatal networks and units have used NNAP results as a basis for identifying and undertaking local quality improvement activities. It is presented by Dr Kate Palmer, Consultant Neonatologist, Royal Stoke University Hospital Neonatal Intensive Care Unit. You can download the full case study below.


Prior to 2014, we only completed outcome forms in BadgerNet for babies for whom Bayley lll two year assessments were performed.

The NNAP 2014 Annual Report on 2013 data showed that we only had five babies for whom we had sufficient data for determining level of impairment.

What we did

  • Increased flexibility in the timing of appointments including offering morning or afternoon options
  • Reviewed all two year follow up forms in BadgerNet, including those for children who did not attend for Bayley Scales III assessment
  • Assessors encouraged to complete all fields when entering data
  • Used the electronic patient record to review the neonatal follow up clinic letters of children who did not receive a Bayley scales III assessment and used this to add information to the BadgerNet 2 year follow up form
  • Asked colleagues seeing eligible babies in the neonatal follow up clinic to enter two year follow up data on the BadgerNet form even if they were expecting the child to attend for a Bayley assessment

What we achieved

The results of the quality improvement activities undertaken are shown below.

Year Number of eligible babies Number of babies with no 2 year health data entered at all Number of babies indicated as not having had a 2 year follow up consultation Number of babies with details of health data entered from a 2 year follow up consultation
2013 24 2 17 5 (21%)
2014 42 0 6 36 (86%)
2015 46 2 9 35 (76%)

In addition, for babies born between 1 July 2013 and 30 June 2014, whose two year follow up data will appear in the NNAP 2017 Annual Report on 2016 data, we have written to the health visitors of children who either failed to respond to the invitation to attend a Bayley assessment or failed to attend the appointment for information on the developmental outcomes of these children.