NELA eNewsletter - 27th Edition April 2016

National Emergency Laparotomy Audit

Patient Data Collection

We are now more than four and a half months into Year 3 of the NELA Patient Audit and are very pleased with hospital participation thus far. Many of the sites taking part have continued to enter the majority of their qualifying procedures, thus ensuring that an accurate picture of emergency laparotomy at their hospital is being collected. There remains, however, some room for improvement. A number of participating hospitals are still falling behind slightly on the data collection and entry process and a portion of qualifying procedures are as a result not making their way onto the database.

You'll have noticed that since the beginning of Year 3 the rating system for the monthly Hospital Progress Lists has changed. In order to be rated 'Green' your site will now have to have a case ascertainment rate of 80% or above. The NELA Project Team is making a massive push this year to increase its overall case completion rate to 80% and we very much need your help to do so. Remember NELA is an ongoing audit and now more than ever hospitals should be making sure that every single qualifying procedure taking place is being entered onto the web tool and the patient data is being completed.

Should you have any questions regarding the best way to capture and enter patient data for NELA or to increase engagement in the audit at a local level, please don't hesitate in contacting the NELA helpdesk.

Quality Improvement Dashboard

As always, we would like to strongly urge web tool users to take advantage of the Quality Improvement Dashboard available on the online web tool. The QI Dashboard is the easiest way to see how you're performing in meeting key process measures and how your performance compares to that of the national average. By using the date-range function you're able to isolate your Year 2 or Year 3 results so as to get an idea of what to expect from the upcoming Patient Audit Report. The QI Dashboard feeds back information on the following key measures:

• Interval from decision to operate to arrival in theatre
• Preoperative documentation of risk
• Consultant Surgeon present in theatre
• Consultant Anaesthetist present in theatre
• Consultant Surgeon & Consultant Anaesthetist present in theatre
• Direct postoperative admission to critical care for all patients
• Direct postoperative admission to critical care for high-risk patients

Second NELA Patient Report

The members of the NELA Project Team have spent the last few months working hard on analysing the over 24,000 patient cases that were collected during Year 2 of the Patient Audit and creating our next report. The Second NELA Patient Audit Report is therefore currently in the process of being completed and is due to be published at the end of June 2016. It will report on specific process and outcome measures, including mortality, by breaking down results on a hospital level, as well as explain how processes have changed from Year 1 to Year 2.

Just like for our first Patient Report, the Year2 report will be published online on the NELA website. We will of course make an announcement closer to the publication day, but if you would like to have a look through the report we've published so far please visit our reports page 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:

Colorectal Anaesthetists Group UK Annual Meeting
25 April 2016, Manchester
Mike Bassett (NELA Research Fellow) Speaking

Association of Surgeons of Great Britain and Ireland (ASGBI) International Surgical Congress
4-6 May 2016, Liverpool
Iain Anderson (NELA Clinical Advisor) Speaking & NELA Trainee Prize

Age Anaesthesia Association (AAA) Annual Conference
26-27 May 2016, Derby
Mike Bassett (NELA Research Fellow) Speaking

Midland Society of Anaesthesia (MSA) Meeting
17 June 2016, Birmingham
Mike Bassett (NELA Research Fellow) Speaking

Association of Coloproctology of Great Britain and Ireland (ACGBI) Annual General Meeting
4-6 July 2016, Edinburgh
Iain Anderson (NELA Clinical Advisor) Speaking

Additional Useful Tools on NELA Website

Guide for calculating observed/expected mortality ratio - Instructions for calculating how your hospital's in-patient mortality rate compares to the expected mortality based on preoperative risk assessment
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
Patient and Organisational Audit Action Plan - Provides an action plan to assist hospital sites in ensuring they are meeting all recommendations laid out in the NELA Patient and Organisational Reports
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 commenced
• June 2015: First Patient Report published
• Dec 2015: 3rd year of data collection for patient audit commenced
• June 2016: Second Patient Report to be published

Contact info:

If you have any questions or would like to contact the project team email -