The 2024 Florence Nightingale Award for Excellence in Health and Care Analytics was awarded to the Perinatal Institute for their groundbreaking research and creation of an app that helps NHS trusts better assess increased-risk pregnancies, significantly reducing rates of stillbirths. With nominations for the 2025 award in collaboration with the Health Foundation still open, we caught up with them about how the project is going…
How has the recognition from winning the award impacted the team?
We are a multi-professional organisation made up of clinicians, developers, IT and data analysts. The team has been delighted to receive the award, as such awards validate our hard work and reinforce our commitment to improving healthcare through data-driven insights.
How has the introduction of the Projected Optimal Weight Range method changed clinical practice in maternity care so far?
The POWR method for assessing fetal growth velocity has resulted in the identification of pregnancies at risk of stillbirth that would have otherwise been missed using conventional assessment of fetal size alone. The method is already integrated into the GROW 2.0 application and used during everyday clinical care. As a result, fetuses with slow growth are flagged to alert clinicians.
Analysing the first full year of implementation, we’ve seen in the 44 NHS trusts that implemented GROW 2.0. that stillbirth rates reduced significantly by 23% compared to the preceding three years of the same units, where POWR velocity assessment was not available.
What feedback have you received from clinicians and healthcare professionals using the Growth Rate Calculator?
The growth rate calculator is incorporated into the upgraded GROW 2.0 software and the best feedback we had was that it has been quickly accepted, part of routing care, and responsible for improved outcomes. We have also received positive feedback from units not within the program and researchers who have used the application.
Your project made sure to involve people in all areas of maternity care. What kind of feedback have you received from parents regarding its impact?
We’re not a parent facing organisation, but we interact with and support clinicians including midwives and doctors. They relay to us how useful these tools are and how much difference they’re making.
What lessons have you learned from this project that might be applicable in the future of public health data analysis and in your own future projects?
One key lesson we’ve learned is not to assume that a metric or tool included in national recommendations is necessarily the best possible method for saving lives.
Prior to POWR’s development, national recommendations had included a 50 centile drop in serial estimated fetal weight as the definition of slow growth. In the absence of evidence, this was based on a consensus definition. We instead undertook the research to firstly develop a novel method that addresses clinical need as well uncertainty in ultrasound based estimation of fetal weight, and secondly validated it through comparative analyses using existing methods. This showed that the conventionally proposed 50 centile drop occurred in only 0.7% of cases, meaning it missed a lot of cases that had slow growth that were at significantly increased risk of stillbirth.
How do you see the integration of data analytics in public health evolving in the coming years?
As health systems becoming increasingly digital and are collecting ever more information, artificial intelligence aided clinical decision making is going to have a much larger role in healthcare and its impact can be massive.
It is important that any decision model, before being implemented, is clinically validated and its performance constantly monitored. We do this for the POWR method by providing live PowerBI dashboards displaying collated results.
The methodology was published open access. Why was this important, and what impact has open access had on its uptake and further research?
Open access tools and publication allows researchers and policy makers from all backgrounds around the world to access and validate our work without financial barriers. This is important as it increases the reliability of our model by being performed by other researchers in international databases.
It allows low-resource countries to evaluate and validate the POWR method to include in their national recommendations. We have also heard from academics working in low-resource countries such as in South America, that this is proving useful for managing pregnancies.
Do you have any advice for this year’s applicants or those looking to undertake similar projects?
In projects relating to health care, engaging with the clinicians who’ll be using your work early and at all stages is important to ensure that your work produces relevant as well as impactful results. Presenting methods and results at research meetings also enables important feedback and confirms whether you are on the right track.
Enter this year’s Florence Nightingale Award for Excellence in Health and Care Analytics by midnight on Wednesday 30 April.