Feasibility and reliability of clinical coding surveillance for the routine monitoring of adverse drug events in New Zealand hospitals.

Aim: To explore the feasibility and reliability of Clinical Coding Surveillance (CCS) for the routine monitoring of Adverse Drug Events (ADE) and describe the characteristics of harm identified through this approach in a large district health board (DHB).

Method: All hospital admissions at Waitemata DHB from 2015 to 2016 with an ADE-related ICD10-AM code of Y40-Y59, X40-X49 or T36-T50 were extracted from clinical coded data. The data was analysed using descriptive statistics, statistical process control and Pareto charts.

Improving quality of clinical coding of post-partum haemorrhage: the process and its effects on reported incidence rates in a New Zealand hospital maternity service.

Aim: The Waitemata District Health Board (DHB) aimed to investigate and improve the accuracy of its reporting of post-partum haemorrhage (PPH), to understand its true incidence.

Method: The quality improvement project included multidisciplinary collaboration between maternity clinicians and clinical coders, substantive redesign of the Waitemata DHB's birth documentation form, systematic auditing and follow-up of clinical documentation by a dedicated quality midwife, linking of maternity clinicians to a key designated senior coder and ongoing PPH incidence monitoring and staff education.

Results: The coded rate of PPH has risen dramatically and is now in line with expected Australasian incidence levels.