NELA eNewsletter - 15th Edition December 2014

National Emergency Laparotomy Audit

Patient Data Collection

As we enter Year 2 of the NELA Patient Audit and near closer to the 14 January 2015 deadline for completing and locking all cases entered during the first year of the audit we would like to take this opportunity to thank you and your colleagues for your incredible hard work during this past month. In the last twenty days alone we have seen more than 2,500 cases locked, with NELA participants going back and reviewing older cases that had remained incomplete, filling in all missing information and locking them. We are nearing closer and closer to our case ascertainment targets for Year 1 and we have no doubt that should the rate of case completion remain as it is now for the next month we will be able to surpass them.

We would therefore once again like to reiterate the important of going back and completing cases entered during the first months of the audit. There are currently over 1,900 cases on the system that were entered between January and August 2014 that remain incomplete. Many of these are missing the answers to only a few questions and should not take too much time to complete, thus making your hospital's case ascertainment rates for the Patient Report much higher. If possible please take some time to review some of your site's older cases to see for how many of them a complete set of data is now available.

As always we would strongly encourage you to involve as many of your colleagues in the data collection and entry process as possible. The NELA helpdesk is always happy to add new users onto the web tool for you, so if you would like logins to be created for a group previously not involved in the audit, whether it be a new group of surgical or anaesthetic trainees or members of your hospital's clerical staff such as ward clerks, please feel free to send us along a list of names and email addresses to be added.

Additional Changes to Year 2 of the Patient Audit

We will be implementing some additional changes for the second year of Patient Audit beginning in January 2015. An NHS number validation function will be introduced to Section 1 of the NELA web tool so as to verify that the NHS number being entered onto the system for the patient is valid. Collecting correct NHS numbers is crucial to the data linkage aspect of the audit and we hope this update will prove valuable in ensuring that incorrect NHS numbers are not mistakenly entered. The Project Team would very much like to thank Ms Rachel Amelan, Clinical Lead and Local Administrator for Stepping Hill Hospital, for recommending that this validation be put in place.

The HES number estimates used to calculate each site's expected number of procedures performed which appear on the monthly Hospital Progress Lists have been updated. You will notice therefore that your hospital's monthly case estimate will have likely changed slightly in the December Progress List. For a breakdown of why the numbers have changed for Year 2 of the audit and how the monthly estimates are calculated please see the following NELA news item, here.

Integrated Pathways for the Care of the Emergency Laparotomy Patients

During the recent NELA Quality Improvement Follow-Up Survey many of you indicated that you were in the process of developing an integrated care pathway for the care of emergency laparotomy patients and would find it useful to review the pathways currently used by your fellow participating sites. We are therefore creating a new page on the NELA website with a list of the integrated pathways sent into us by participating hospitals which will be made available at the beginning of January 2015.

We would like to express our deepest thanks to the sites that sent in their pathways currently in use and allowed us to share them with the rest of the hospitals taking part in the audit. If your hospital currently has an integrated pathway in place and you would be willing to have it published on our Pathways page please feel free to email it in to the NELA helpdesk.

NELA Helpdesk - Christmas Cover

The Royal College of Anaesthetists, out of which the NELA Helpdesk operates, will close for the Christmas and New Year break at 1.00 pm on Wednesday, 24 December 2014 and re-open at 9.00 am on Monday, 5 January 2015. We will therefore not be able to address any telephone queries during this time.

We will however be providing cover for the NELA inbox on Monday 29 December and Friday 2 January. Please feel free therefore to email us with any questions you may have and we will do our best to respond via email during one of those two sessions. Full Helpdesk cover will resume on the morning of Monday 5 January 2015.

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:

  • Association of Anaesthetists of Great Britain and Ireland (AAGBI) Winter Scientific Meeting
    14-16 January 2015, London
    Dave Murray (Clinical Lead) & Matt Oliver (Research Fellow) Speaking

  • Royal College of Anaesthetists (RCoA) Anniversary Meeting: Beyond the Boundaries
    11-12 March 2015, London
    Dave Murray (Clinical Lead) Speaking

  • Association of Anaesthetists of Great Britain and Ireland (AAGBI) Core Topics Conference
    25 March 2015, Newcastle
    Dave Murray (Clinical Lead) 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 -