the challenge

In 2024, Ireland's Office of the Nursing & Midwifery Services Director (ONMSD) faced a critical juncture. Their existing platform for the Quality Care Metrics process, the Test Your Care (TYC) system, provided by University Hospital Birmingham, was, approaching end-of-life and would be out of support at March 2025.

With services across the entire country already using Quality Care Metrics on Test Your Care, the scope exceeded a standard like-for-like substitution and demanded a more substantial upgrade to support both business continuity and national strategy. They needed a transformational platform that could:

Scale across Ireland's entire health service, spanning six regional health authorities

• Support 180 healthcare services across Acute, Community and Integrated Care Settings

• Manage nine distinct audit care metric suites across seven care areas, spanning acute, children’s, intellectual disability, public health, older persons, mental health, and midwifery services. Manage 6,000+ users with sophisticated permission structures

• Migrate three years of historical data, including associated complex Quality Improvement Plans (QIPs) and their associated components.

• Meet the Health Service Executive (HSE) rigorous security and compliance requirements

Not having a replacement for the TYC platform posed substantial risk and was time critical for the HSE. Quality care metrics provides a framework to identify gaps in care delivery, enable targeted action planning for improvement, and strengthen accountability for care quality across nursing and midwifery services in Ireland.

The solution

Medical E-Guidance (MEG) was selected through a competitive tender to deliver MEG-QCM, a modern, cloud-based platform designed specifically for healthcare quality benchmarking at a national scale.

Comprehensive Metric Coverage
The platform was configured to support nine questionnaires designed for existing nursing and midwifery quality care-metric suites aligned to evidence-based standards and agreed through national consensus:

Acute Care Services Quality Care-Metrics

1. Children's Services Quality Care-Metrics

2. Intellectual Disability Services Quality Care-Metrics

3. Mental Health Services Quality Care-Metrics

4. Midwifery Services Quality Care-Metrics

5. Older Person Services Quality Care-Metrics

6. Public Health Services Quality Care-Metrics

Enterprise-Grade Architecture
The MEG-QCM platform was architected as a multi-institution deployment spanning Ireland's six Health Regions, with all healthcare facilities configured to enable both local operational autonomy and national performance visibility. Individual facilities manage their own quality metrics while health system leaders gain comprehensive benchmarking across the entire network:

Sophisticated Access Control
To meet HSE's specific governance requirements, MEG configured six user permission groups:

• Collect: designed for data collectors

• Report: designed for managers at organisational level responsible for  quality improvement plan (QIP) management and report generation

• Admin (Level 1): designed for service nominated leads responsible for user access and data management , 

• Admin (Level 2 & 3): designed for regional and national leads

• Executive: designed for national leads responsible for enabling strategic oversight and performance monitoring

Security & Compliance
MEG’s QCM platform is built to meet HSE security standards:

• Advanced password complexity requirements 

• Brute force protection with account lockout

• Configurable session timeouts (90-day password rotation)

• IP address whitelisting capabilities

• GDPR-compliant data handling with formal privacy notices

Real-Time Analytics
The platform delivers immediate visibility into quality metrics through:

• Real-time reporting of monthly QCM data submissions

• Compliance dashboards showing performance across all seven care areas 

• Trend analysis highlighting both exceptional care and areas requiring immediate attention

• Benchmarking capabilities at organisational, regional and national levels 

• Alerts for risk identification

the implementation

The goal of implementing MEG was to improve the hospital's quality management efforts by effectively monitoring and processing information and identifying critical points for improvement. Success would involve the ability to efficiently track critical areas and discern where improvements have been made and where challenges persist. The tool was intended to enable the evaluation of more processes, engage more teams, and focus efforts on critical points to drive more efficient actions. Briefly, the main objectives included:

• Ensure the usability of the tool by efficiently entering large amounts of process data and associated risks using walkthroughs and activities (QR code + photos)

• Optimize dashboard generation and data visualization for smooth operation

• Optimize workflows by selecting the risk group (heat map) with the highest NPR for analysis and identification of improvement opportunities (preventive actions).

• Target a 50% reduction in NPR from early to late stages, our key performance indicator

• Reduce the incident rate per 1000 patient days (balance indicator)

the Implementation

MEG in collaboration with the HSE focused on minimising disruption while onboarding 6,000 users across 180 healthcare services.

Complex Data Migration
The migration represented MEG's largest data migration to date and the project's most technically complex phase. The team successfully:

• Migrated two years of historical audit data associated with nine questionnaires designed for existing nursing and midwifery quality care-metric suites

• Transferred thousands of QIPs with full action tracking

• Created 6,000+ user accounts from UHB data 

• Developed specialised migration tools to handle the data volume and complexity

• Conducted robust data hygiene  and validation checks

BY THE NUMBERS

6,000+ users onboarded with personalised credentials before Go-Live

180 healthcare services deployed simultaneously across all care settings

9 questionnaires configured with advanced subform architecture

2 years of historical data migrated, including complex QIP action plans

6 custom permission groups developed for HSE governance requirements

Zero service disruption during platform cutover

100% on-time, on-budget delivery

Structured Onboarding
To ensure smooth adoption:

• Over 6,000 personalised onboarding emails were distributed before Go-Live

• Emails included customised HSE-specific guidance and GDPR privacy notices

• A dedicated environment with generic accounts was established as a training and practice resource

• Super-user training was delivered through HSeLanD resources (HSE's national learning management system) eLearning modules and webinars

• The ONMSD National Nursing and Midwifery QCM team, on behalf of the HSE managed all communication plans internally

Collaborative Delivery
Successful national implementations require more than technical expertise; they demand a deep understanding of clinical workflows and quality improvement processes.

Drawing on implementation experience across 25 countries, MEG worked closely with the HSE teams including:

• ONMSD National Nursing and Midwifery QCM team 

• ONMSD Clinical Leadership partners

• HSE Business Leads and Procurement teams

• HSE Technology and Transformation staff from Corporate Delivery

This collaborative approach ensured the platform aligned with both clinical governance requirements and frontline user needs. As Ms. Anne King, Senior ICT Projects Manager, notes:

The Results

Go-Live: April 2, 2025, at 9:00 AM

✓ On time
✓ Within budget
✓ 180 healthcare services deployed across all care settings
✓ 6,000 users onboarded and active from day one
✓ Nine questionnaires fully configured and operational
✓ Two years of historical data successfully migrated from legacy platform

Sustained Growth & Adoption

Since ‘Go-Live’, Ms. Biny Anoop, Assistant Director of Nursing (ADON), Nursing and Midwifery Planning and Development Officer, leading on technical developments with the platform nationally, reports steady week-on-week growth in audit data submissions, demonstrating strong platform adoption across all six health regions.

The platform now provides:

• Specific measurement of nursing and midwifery care processes in individual care areas

• Performance monitoring against evidence-based national standards

• Real-time tracking and benchmarking, quantifying trends and care processes

• Risk identification, highlighting areas requiring immediate attention alongside exceptional care

• Targeted action planning for continuous improvement

• Educational insights directing training needs for healthcare staff

• Staff engagement and accountability for delivery of quality care
  
  

Transforming Insights into Impact

Why It Matters

The MEG-QCM platform addresses the core challenge facing healthcare quality leaders: turning data into action.

For Clinical Teams:
Real-time visibility into care gaps enables immediate intervention before issues escalate. Benchmarking across facilities reveals what excellence looks like and where support is needed.

For Quality Leaders:
Standardised metrics across all regions provide clear accountability and allow resources to be directed where they'll have the greatest impact on patient outcomes.

Ms. Michelle Donnelly, NMPD Director and Chair of the National ONMSD QCM group quotes in the Autumn 2025 edition of HSE Health Matters:

For the Health Service Executive in Ireland:
A scalable, cloud-based infrastructure that aligns with national strategic priorities while supporting long-term sustainable,  goals.

By implementing a standardised national solution, Ireland's health services can now benchmark performance across the entire healthcare system, drive continuous evidence-based improvement, ensure accountability and transparency in care delivery, and ultimately deliver enhanced patient outcomes.

As Anne King explains:

MEG-QCM transforms quality data from a compliance exercise into a strategic asset that saves lives.

Looking Ahead

The successful deployment established a strong foundation for continued evolution. A national survey conducted six months post go-live by the HSE, in collaboration with MEG team, focussed on benefits realisation and consideration for further development. 

Both qualitative and quantitative data received provided key insights including potential areas for future development. This included platform optimisation based on user feedback, enhanced analytics capabilities, deeper system interoperability, and expanded metric suites as national standards evolve. 

Feedback from the survey respondents included “the system is great and user friendly”, “I’m not familiar with all the functionalities yet, but I do have a better understanding with supports in place”. Such insights have informed targeted supports and resources where required. The partnership between MEG and HSE continues to mature as both organisations remain committed to advancing nursing and midwifery care quality across Ireland.

About MEG
MEG delivers healthcare quality benchmarking solutions across 25 countries, combining deep technical capability with specialised healthcare expertise to support complex, large-scale national implementations. Our cloud-based platform provides the robust infrastructure, advanced security, and sophisticated analytics that healthcare systems need to drive measurable improvements in care quality.

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