NELA eNewsletter - 21st Edition June 2015

National Emergency Laparotomy Audit

Patient Data Collection

As we are now well past the half way mark for Year 2 of the Patient Audit we must once again stress the importance of the data entry process. Not only entering qualifying patients onto the online system, but also making sure that the full dataset for each patient is completed once it becomes available and that the case is then locked. The graph below shows the number of cases entered and locked for the audit during the first four months of Year 2 based on date of patient admission:


As you can see the number of procedures entered for each month remains steady at roughly 1,900 cases/month; the number of these cases being locked is on average below 1,500/month. This means that hundreds of cases are being entered onto the system each month that aren't being completed and locked. We understand that long-stay patients who've yet to be discharged cannot be completed on the web tool, but the majority of patients who were operated on prior to April 2015 will have now been discharged.

Remember that just like during Year 1 of the Patient Audit a case can only be included in NELA and the report if it's been locked. We would therefore encourage all NELA participants to have a look through some of their earlier Year 2 cases to see how many remain incomplete. Full information will now most likely be available for these patients, and the earlier the information is entered the easier it will be for you to complete each case.

First NELA Patient Report - Publication & Launch

After months of data analysis and multidisciplinary collaboration the audit's Project Team is absolutely thrilled to announce the first NELA Patient Report will be released in just one week's time. On Tuesday, 30th June 2015 the Patient Report will be published on the Reports page of our website, here.

The Patient Report will focus on patient data collected during Year 1 of the audit, from January 2014 until November 2014. It will feature key findings and results, highlight best practices currently in place across certain NHS hospitals and make recommendations for hospitals performing Emergency Laparotomy to implement. Compliance with standards and process measure results will be broken down by hospital and trust, so participants will be able to see how well they compare to other sites in their region or of similar size.

This Report represents not only the efforts made by the members of the Project Team in preparing it, but more importantly the countless hours of hard work put in by local hospital NELA leads and participants who have worked tirelessly to ensure that accurate and thorough patient information is captured and fed back to the NELA team. Without the incredible help received by hospital staff who have embraced and carried out the audit this Report would not be possible. It is for this reason that we would once again like to express our deepest gratitude towards everyone involved in the audit, your efforts are very much appreciated.

The Patient Report will be officially launching at the 15th EBPOM Congress in Evidence Based Perioperative Medicine on Tuesday 30th June which will be taking place at the Institute of Education in London. The audit's National Clinical Lead, Dr Dave Murray, and Quality Improvement Lead, Dr Carol Peden, will both be speaking at the event, with the Report presentation taking place on Tuesday morning from 10:00-11:00.

NELA Sponsored Trainee Poster Prize at the AAGBI Winter Scientific Meeting

The Project Team are pleased to announce that we will be sponsoring a Trainee poster prize at the upcoming Association of Anaesthetists of Great Britain and Ireland (ASGBI) Winter Scientific Meeting taking place from 13-15 January 2016. This is for the best poster that uses local hospital NELA data to bring about an improvement in the quality of care.

Although NELA has the word 'Audit' in it, the only way improvements in patient care will come about is if clinicians use their audit data to measure what is going on in their hospitals, make a change and measure the impact of making that change. The web tool allows NELA local reporters to download local audit data at any time to support such QI initiatives.

Our intention is that this prize will encourage trainees to get involved in driving improvements in the delivery of care to patients undergoing emergency laparotomy. It also has the added benefit of fulfilling some of the requirements of the CCT in Anaesthetics in Annex G. At the basic level, trainees need to 'Understand the difference between audit and quality improvement' with 'Evidence of active participation in a Quality Improvement project'. At Advanced level, it asks for 'Presentation of a Quality Improvement project through poster, case study or oral presentation ideally at a regional, national or international quality forum'.

The criteria for a successful poster will be judged on whether it demonstrates use of local NELA data , it uses established QI methodology, has multidisciplinary involvement, and whether it demonstrates an improvement in care, which could be improvements in process or outcome. The closing date for abstract submissions is 23:59 on Monday 31 August 2015 and a cash prize will be awarded to the winner. For more information and to submit your abstract please visit here. (Website will be updated with 2016 information in the next few weeks.)

2015 Events Featuring NELA Speakers

The following events will also feature members of the NELA Project Team speaking about and answering questions on the audit:

Evidence Based Peri-Operative Medicine (EBPOM) Annual Congress
29 June - 3July 2015, London
Dave Murray (Clinical Lead) and Carol Peden (Quality Improvement Lead) Speaking

Association of Anaesthetists of Great Britain and Ireland (AAGBI) Annual Congress
22-25 September 2015, Edinburgh
Dave Murray (Clinical Lead) Speaking

Association of Anaesthetists of Great Britain and Ireland (AAGBI) Core Topics Conference
8 October 2015, Leicester
Emma Davies (Surgical Research Fellow) Speaking

Royal College of Anaesthetists (RCoA) Recent Advances in Anaesthesia, Critical Care and Pain Management
2-4 December 2015, Birmingham
Mike Grocott (NELA Chair) Speaking

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 -