NELA eNewsletter - 9th Edition May 2014

National Emergency Laparotomy Audit


Organisational Audit

The National Emergency Laparotomy Organisational Audit Report was published on Wednesday the 14th of May 2014. The organisational audit collected information on the structures and processes that contribute to the delivery of care to patients undergoing an emergency laparotomy within 190 of 191 hospitals taking part in NELA. The report's Executive Summary was sent to all participating trusts' Chief Executives prior to the publication day.

Our deepest thanks go out to all the hospital NELA leads without whom the publication of the Organisational Report would not have been possible. We would also like to thank those of you who attended the report's launch at the Royal College of Anaesthetists' Annual Congress in Cardiff on the 16th of May. We hope you found Dr Dave Murray's speech on the findings of the report and the progress of the patient audit interesting and insightful.

To download a copy of the full report as well as the Executive Summary please click here.


Patient Data Collection

As many of you know, last week we made available to all hospital Local Leads a table listing the progress of all 191 hospitals participating in the NELA patient data collection. The table provided figures for the number of cases entered and locked during the first four months of the data collection period, as well as how each site's case numbers compared to that of the expected number of emergency laparotomies taking place based on Hospital Episode Statistics (HES) figures. The publication of this list was in no way meant to point fingers at some of the lower performing sites, but rather to give hospital leads an idea of how their collection numbers compare to those of their fellow participating hospitals.

Since the list has gone out we have had several questions regarding the accuracy of the HES numbers. We understand this concern and are quick to point out that these are estimates of emergency laparotomies taking place at each site. These figures have been derived by taking averages of qualifying procedures that have taken place at each hospital over the last six years, so there is bound to be some degree of variation when comparing the HES numbers to the number of cases entered onto the system.

We hope that you have found this table useful and it's given you a clearer picture of where along the patient data collection process your hospital is. Our plan at this point is to release an updated version of this table to all hospital leads on a monthly basis. You are therefore encouraged to constantly try and increase your data collection and completion rates so that they're higher with each list that is published.


Completing and Locking Cases

One issue this table brings to light is that of cases still not being completed and locked at the same rate at which they are being entered. Four months into the patient audit we are very pleased with amount of cases that have been added to the system, almost 70% of all eligible cases taking place. Of the over 7500 cases entered however over 52% of them remain incomplete with less than 41% of them locked. This leaves an additional 500+ cases that are complete but are yet to be locked.

Completing and locking cases is crucial in the data collection process and it's what allows you to export and analyse the patient information to assist with quality improvement.
Many of you have spent a great deal of time and effort making sure that patient cases are added onto the system. We therefore strongly encourage you to insure that this data is not lost and that these cases are 100% completed and locked.
If you are one of the hospitals with a high number of incomplete cases and completed cases that remain unlocked our wish is that this table motivates you to begin filling in any missing or incomplete data.


NELA Top Tips

Since the distribution of our last Participant Newsletter we have seen the publication of our NELA Top Tips document. This list is compiled of some of the most useful and effective advice that was sent into us by fifteen of the top performing NELA sites. The list includes tips on how best to make sure that all eligible cases are being entered onto the system, that patient information is being completed once added to the web tool and that NELA is being treated and carried out as a multidisciplinary project, with both surgical and anaesthetic involvement.

The Top Tips document can be found under the documents section of NELA website, here.


Useful Tools on NELA Website

  • Frequently Asked Questions - Constantly updated FAQs reflect the most common and recent queries we receive from hospital staff and web tool users
  • Help Box Text - Provides additional assistance for filling in each of the data collection questions and can also be found on the web tool by clicking on the 'H' button to the right of every question
  • Proforma - A PDF copy of the latest Proforma, the online data collection questionnaire, that can be printed and filled out with patient information in real time, making it then easier to transfer all the information onto the online web tool
  • Updated Inclusion & Exclusion Criteria
  • NELA Poster & Leaflet - To publicise the audit amongst staff and patients in the hospital
  • OPCS Labels - For procedure items in the NELA dataset
  • Process Outcome Measures
  • Organisational Audit Link to Standards


Sign up to receive the NELA newsletter

The NELA project team will be regularly publishing a newsletter informing those interested and/or participating in the audit on the latest developments.

If you would like to receive the newsletter for regular updates please sign up to the mailing list here.


NELA Twitter

The National Emergency Laparotomy Audit has launched its own twitter account. This will provide updates, news and links to important information on the NELA website. You can follow us @NELANews


Key dates

  • Complete: Organisational audit
  • Jan 2014: 1st year of data collection for patient audit commenced
  • May 2014: Organisational Audit Report published
  • Dec 2014: 2nd year of data collection for patient audit commences
  • July 2015: 2nd Report Published (1st patient audit)


Contact info:

If you have any questions or would like to contact the project team email - info@nela.org.uk