Quality Improvement Resources

PICANet’s key quality improvement (QI) resources for participating organisations are detailed below. 

If you have conducted an effective QI project involving PICANet data/ using any of these resources we would like to hear from you. Please contact us at picanet@leeds.ac.uk 

PICANet's Key Metrics

PICANet’s key metrics cover the whole patient pathway from initial referral to paediatric intensive care, specialist transport, and inpatient care.  

The PICANet Key Metrics Definitions details the current metrics and the Supporting quality: PICANet’s key metrics document outlines the processes and quality improvement resources available to aid participating organisations to collect complete, good quality data that feeds into the metrics and respond to areas that show as a cause for close monitoring or concern. 

Risk-adjusted resetting sequential probability ratio test (RSPRT) plots
Real-time ‘RSPRT’ plots enable PICUs to monitor their mortality outcomes on a timely and regular basis. RSPRT Guidance for Units is available to assist PICUs in identifying and responding to potential issues with quality of care in a time-sensitive fashion. The guidance includes a case study from a PICU team that responded to a RSPRT reset which was a cause for concern requiring internal review. Further to the case study in the guidance, the PICANet Annual Meeting 2022 discussion session, PICANet RSPRT in PICU, is available on our website. This features two PICU clinicians talking about their experience of using RSPRT plots to monitor mortality in their units.  

Having a cause for concern RSPRT status does not mean that the PICU will be identified as a potential outlier in the formal outlier analysis which is based on standardised mortality ratios. Should a unit be identified as a potential positive or negative statistical outlier for risk-adjusted in-PICU mortality, the PICANet Outlier Policy will be followed.  

National Clinical Audit Benchmarking Program (NCAB), England                                                                            PICANet’s key metrics are reported to the Care Quality Commission (CQC) annually to inform inspection planning of NHS and private hospitals in England and are publically available on the NCAB portal along with each provider’s performance the previous year, the national average and, where applicable, national standard. 

PICANet Data

Local data downloads                                                                                                                                                                        All participating organisations are able to access real-time local data downloads and reporting to support and stimulate QI discussions. 

Tables and figures
Tables and figures are provided with each annual State of the Nation Report. These are provided on the Reports and publications page for the latest report and in the Annual Report Archive for previous editions. The tables and figures are in an accessible Excel Workbook format to enable participating organisations to assess and monitor their performance against other PICUs or centralised transport services to inform local and regional QI initiatives. 

PICANet Data Dashboard

The PICANet Data Dashboard is a selection of charts showing data relating to some of PICANet’s key metrics. Clinical teams involved with patient care can use these along with other resources that PICANet provide to develop local quality improvement strategies and compare compliance with audit performance metrics.

Data Collection Resources

PICANet’s data manuals and guidance are available online.

Ethnicity Data Collection

Guidance and resources for asking about ethnicity, collecting and recording it are available from Ethnicity – NHS Digital, which signposts to Improving ethnicity data collection for health statistics in the UK (IQBAL, Gulnaz, GUMBER, Anil, JOHNSON, Mark R.D, SZCZEPURA, Ala, WILSON, Sue and DUNN, Janet A (2009). Improving ethnicity data collection for health statistics in the UK. Diversity and Equality in Health and Care, 6 (4), 267-285).

Healthcare Associated Infections Data Collection

PICANet provide expanded dataset definitions and frequently asked questions for the healthcare associated infections (HCAI) data. This includes some example scenarios for determining PICU-acquired central line associated bloodstream infection (CLABSI) according to the criteria.

If your unit has designated personnel who are instrumental to gathering, recording and validating HCAI data for submission to PICANet, please do make PICANet aware of them so that we can direct any specific data validation queries to them.

For further information on CLABSI and catheter associated urinary tract infection (CAUTI) you can refer to:

  1. The UKHSA’s Infection in Critical Care Quality Improvement Programme (ICCQIP)
  2. The Joint Commission CLABSI Toolkit

Further general information surrounding HCAI can be found here:

  • epic3: National Evidence-Based Guidelines for Preventing Healthcare-Associated Infections in NHS Hospitals in England                                                                                                                                                                                Loveday HP, Wilson JA, Pratt RJ, Golsorkhi M, Tingle A, Bak A, Browne J, Prieto J, Wilcox M, UK Department of Health. epic3: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. J Hosp Infect. 2014 Jan;86 Suppl 1:S1-  70. doi: 10.1016/S0195-6701(13)60012-2. PMID: 24330862; PMCID: PMC7114876.

These articles regarding CVC bloodstream infections in ICU:

Delirium Screening Result Data Collection

If personnel in your PICU are trained to use one of the following screening tools (or any other validated paediatric delirium screening tool, e.g. pCAM-ICU or psCAM-ICU) adopted by your unit, then delirium screening result data can be completed.

  • Cornell Assessment of Pediatric Delirium (CAPD); or
  • Sophia Observation withdrawal Score-Paediatric Delirium (SOS-PD)

Units not using a validated paediatric tool for screening should leave these fields blank until screening is introduced. The CAPD tool is the most commonly used screening tool.

The Paediatric Delirium Group UK and Ireland (PDGUKI) make training and screening resources for the CAPD tool available online. They also provide guides and templates for screening compliance audits for the CAPD and SOS-PD tools.

The group host monthly virtual meetings to facilitate shared experience of establishing delirium screening within PICUs across UK & Ireland. The meeting schedules can be found on their website.

PICANet are in regular contact with the team at PDGUKI to find out which units have completed training and started screening. we will contact those units to confirm data entry start dates for validation to commence.

Validation will be switched on to the first batch of units that have commenced screening in February 2024. Full details will be provided directly to units.

PICANet Reports and Meetings

The latest annual State of the Nation Report is available on the Reports and publications page and previous editions are available in the Annual Report Archive 

Traditionally PICANet host an Annual Meeting for participating PICUs and Specialist Retrieval and Transport Services. PICANet report findings are presented and associated QI topics discussed.  

Video recordings of the talks given at the Annual Meeting held on 26 Jan 2022 are available on our website.