Epidemiological and outcome data from pregnancies complicated by pre-existing diabetes and gestational diabetes are ‘patchy’ in Australia and New Zealand. There are some centres that retain an ongoing internal audit, while others have no systematic process to review their care. A national clinical audit programme can provide an implementation framework for those centres interested in reviewing and improving their care, and provide benchmarking support for those with established audit activities. ADIPS carried out a pilot study of 3 approaches to clinical audit (paper, stand alone electronic, networked electronic) across 9 different clinical settings (rural, urban, large proportion of indigenous, New Zealand) linked with a Benchmarking Centre in 2007 (Australian and New Zealand Journal of Obstetrics and Gynaecology 2007;47:198–206). Based on the findings of that exercise, and developments in the field since, a revised dataset, a data dictionary, a process for de-identification of patients and sites and proposed central data analysis and reporting site protocols have been developed to establish/pilot a clinical audit in 2018-2019. Aspects of Ethics and Permission need to be identified and defined. Local reports and a national report will be created allowing benchmarking of clinical performance across sites (and against existing Clinical Guidelines and Best Practice). The proposed system will only be able to support analysis of De-identified Electronic Data. It may be appropriate to establish systems for Type 1 and Type 2 diabetes only initially, although if GDM data exists, this would likely be possible. The audit process will be offered across all interested sites in Australasia and be undertaken at least every 12 months. A key issue currently is a source of ongoing funding for administration and benchmarking.
Thanks to the working group for their work.