NELA eNewsletter - 19th Edition April 2015

National Emergency Laparotomy Audit

Patient Data Collection

As always the NELA Project Team would like to strongly encourage audit participants to ensure that all qualifying procedures are being entered onto the data collection web tool and included in the audit. Equally important however is making sure that once a patient case makes its way onto the system all required data is completed and the case is eventually locked. Remember just like during Year 1 of the Patient Audit a case can only be exported by the Project Team and its data used for analysis if it has been locked. Make sure therefore that the hours of hard work in collecting and entering the patient data is not lost by ensuring that all cases entered for your hospital are locked.

Over the next month or so we will be contacting individual hospitals that have not yet been fully participating in Year 2 of the Patient Audit. These will be sites who have either stopped entering the majority of their qualifying procedures onto the system or that have been failing to complete any of the cases entered. If you feel that your hospital is most likely one of these sites and you would like to avoid being singled out as one of our underperforming participants we strongly encourage you to take the next few weeks to catch up on the data entry and completion process.

Updates to the NELA Web Tool

Over the last month we have introduced a number of exciting changes to the online web tool which we hope will make the process of completing cases and analysing data easier.

60-day inpatient cut-off point

In the lead-up to the deadline for all Year 1 cases to be completed and locked we received a number of emails from Local Leads asking about patients who despite being operated on months prior to the deadline had not yet been discharged.
We have therefore come up with a permanent solution to deal with long-stay patients by adding a 'Still in hospital at 60 days' answer option to question 7.7. This option will only become available once 60 calendar days have passed since the date of entry into operating theatre and once selected, question 7.8 relating to the date of patient discharge will be greyed out. We very much hope this update will make the process of locking cases on the web tool easier and ensure that cases can always be completed within two months of the date of operation.

Date ranges on the web tool

You may have noticed a change to the Patient Data Entry page on the web tool with the addition of date range tabs. These allow you to filter your caseload by date of admission should you wish to isolate a certain group of patients in the list. For example therefore if you wanted to look solely at cases for Year 2 of the Patient Audit you would enter 01/12/2014 in the 'from' date range field. This will automatically hide all Year 1 cases from the case list.

Updated export function

Over the last few months we've had several local hospital leads explain to us that in addition to the web tool export currently available an additional 'text answer' export would also prove to be useful. While the initial export uses codes for each case's answers, thus making it easier for the patient data to be analysed using graphs and tables in Excel, it also requires the use of the Export Key. We completely understand therefore the practicality of an export which lists the data in text form rather than coded.

As a result we have now introduced two new export types under the Export screen, the 'Text version' and 'Text version with database codes'. As the names suggest the former will display the patient information solely in text, while the later will give you both the text and the codes outlined in the Export Key. The Project Team strongly encourages NELA participants to take advantage of the web tool's export function as a ways of analysing audit results on a hospital level and carrying out any local Quality Improvement initiatives that may be taking place.

If you find that you do not have access to the Export page on the web tool please get in touch with your hospital's NELA Local Administrator to request your account be given Reporter Privileges, or simply contact the NELA helpdesk directly.

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 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

Age Anaesthesia Association (AAA) Annual Conference
14-15 May 2015, Manchester
Matt Oliver (Research Fellow) Speaking

Evidence Based Peri-Operative Medicine (EBPOM) Annual Congress
29 June - 3July 2015, London
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

Patient Safety in Perioperative Practice

Monday 11th May 2015
Royal College of Anaesthetists, London

A one day meeting to discuss patient safety, including the barriers to delivering safe perioperative care, and strategies on how to overcome them. The aim of the day is to build upon existing knowledge to make systems, processes and organisations safer: Using the science of patient safety, drawing upon previous errors, cognitive psychology and the use of education (including simulation) and quality improvement programs, to improve patient care.

For further information including the latest programme or to book a place for the event please follow the link here.

Additional Useful Tools on NELA Website

Participant Manual - A compilation of all useful NELA background information and documents, the perfect introductory tool for a hospital user new to the audit
Audit Protocol Document - Provides an outline on the structure of the audit, as well as all professional stakeholders involved
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 -