NELA eNewsletter - 16th Edition January 2015
National Emergency Laparotomy Audit
Patient Data Collection
We are now only a few days away from our extended 26 January 2015 deadline by which all Year 1 cases need to be completed and locked, this is the last chance for participating hospitals to finalise any pre-December cases they'd like included in the first NELA Patient Report. If you are in the process of filling in any last-minute patient information on the web tool or transferring some data from a paper form to our online system please note that this needs to be completed by the end of the day on Monday the 26th of January.
The feedback we received upon extending the deadline from the 14th to the 26th has been incredibly positive and we hope these additional twelve days have proved to be very useful in getting the last of your Year 1 data onto the web tool. We have seen a number of cases completed and locked these last two weeks and as of this morning we are incredibly happy to report that there will be over 20,000 locked cases included in Year 1 of the NELA Patient Report. It is a number that greatly exceeds our initial case ascertainment predictions and one with which we are extremely pleased. The Project Team fully acknowledge that this milestone would never have been reached without the incredible hard work from the local NELA hospital participants, so we would once again like to express our deepest thanks for helping us achieve this.
As Year 1 of the NELA Patient Audit therefore comes to a close and we move fully into Year 2, we would again like to remind you that NELA is on ongoing audit. At the current time the patient data collection period is schedule to take place until the end of November 2015, with the possibility of a two-year extension. We very much hope that the process of collecting and entering the patient data has become easier on a local level and that we can begin capturing patient data for the audit at an even higher rate than during Year 1.
Completing Long-Stay Patient Cases
One of the more highly discussed topics amongst the Project Team is how to address the long stay patient who despite being operated on during Year 1 of the audit have not yet been discharged, making it impossible for the cases to be completed and locked. While it was first thought the best option would be to include these cases in Year 2 of the Patient Audit, it was agreed that this would be unfair on the hospital staff performing the data entry as it would require them to monitor a patient's status indefinitely until the case could finally be completed.
We have therefore decided to set a 60 day post-operative cut-off point for the patient to be discharged. If a patient has yet to leave hospital within 60 days of the surgical procedure which is included in the audit, the case can be completed and locked. The date the case is being locked can be used as the discharge date and 'Status at Discharge' being recorded as 'Alive'.
We very much hope that this will help in reducing some of the data collection burden and allow you to contribute even more cases towards Year 1 of the audit. Please have a look through your hospital's cases; if there are any patients who were operated on over 60 days ago and who have yet to be discharged please feel free to now lock these cases and enter the present date as the 'date of discharge'.
Web Tool Export Function for Quality Improvement
With most participating hospitals now finalising their cases for Year 1 of the audit we want to make sure that this patient data, along with the hours of work that went into collecting it, can be used locally for any sort of local review or Quality Improvement initiative. Instead of simply submitting this data to us and waiting six months for a report to be published, the Project Team is strongly urging sites to begin analysing their processes and outcomes now.
The best way to do this is by utilising the web tool's Export function. This allows users to transfer all their patient data onto an Excel spreadsheet from where it can be analysed and graphs and charts can be created allowing hospitals' Clinical Audit teams to examine specific QI indicators. If you do not currently have access to the web tool's Export function and would like to be able to view your hospital's results on a spreadsheet format please contact your site's NELA Local Administrator or the NELA helpdesk and request that your account be granted Reporter Privileges. A key to assist you in analysing the export results can be found under the 'Support' tab on the web tool.
Integrated Pathways for the Care of the Emergency Laparotomy Patients
The Project Team would once again urge sites that do not currently have an integrated care pathway for patients undergoing Emergency Laparotomy in place do take advantage of our Pathway Examples page on the NELA website. We are constantly updating the page with new pathways being sent into us from sites that have one in place, so with many of you recently indicating that you are in the process of creating an integrated care pathway for your own site we strongly encourage you to take advantage of this resource. The Pathway Examples page can be found here.
Upcoming Events Featuring NELA Speakers
The following events will also feature members of the NELA Project Team speaking about and answering questions on the audit:
• The Association of Surgeons in Training (ASiT) Conference 2015
17 February-1 March 2015, Glasgow
Emma Barrow (Surgical Fellow) Speaking
• Royal College of Anaesthetists (RCoA) Anniversary Meeting: Beyond the Boundaries
11-12 March 2015, London
Dave Murray (Clinical Lead) Speaking
• Royal College of Anaesthetists (RCoA) HSRC/QuARC Meeting
17 March 2015, London
Dave Murray (Clinical Lead) and Matt Oliver (Clinical Fellow) Speaking
• Association of Anaesthetists of Great Britain and Ireland (AAGBI) Core Topics Conference
25 March 2015, Newcastle
Dave Murray (Clinical Lead) Speaking
• Association of Surgeons of Great Britain and Ireland (ASGBI) Core Topics Conference
22-24 April 2015, Manchester
Emma Barrow (Surgical Fellow) Speaking
• Royal College of Anaesthetists (RCoA) Spring Symposium
14-15 May 2015, Edinburgh
Dave Murray (Clinical Lead) Speaking
• Association of Anaesthetists of Great Britain and Ireland (AAGBI) Annual Congress
22-25 September 2015, Edinburgh
Dave Murray (Clinical Lead) Speaking
Additional Useful Tools on NELA Website
• Outlier Policy - Sets out the process by which participating hospital performance will be assessed and the process the NELA Project Team will follow to manage any hospital that is found to fall outside the expected range of performance and therefore flagged as an outlier
• Organisational Audit Action Plan - Provides an action plan to assist hospital sites in ensuring they are meeting all recommendations laid out in the NELA Organisational Report
• Set of Slides - A PowerPoint presentation focusing on the key findings of the NELA Organisational Report and how the report strongly emphasises the need for patient data to be collected and analysed
• Top Tips - List compiled of some of the most useful and effective advice that was sent into us by a number of the top performing NELA sites
• 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
Certificate of Participation
To receive your copy of the NELA Certificate of Participation please contact your hospital's Local Administrator to request that a certificate be issued for you.
Organisational Audit Report
To download a copy of the full NELA Organisational Report as well as the Executive Summary please click here.
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
