NELA e-Newsletter - 29th Edition September 2016

Welcome to the National Emergency Laparotomy Audit's e-Newsletter.

NELA Organisational Audit - 2016

The NELA Project Team would like to announce that in OCTOBER 2016, we will be conducting Second NELA Organisational Audit.

We will be sending out the precise dates and more information about the content of the Organisational Audit very soon. Once the Organisational Audit is launched it can be accessed through the online NELA web tool and only one Organisational form is required per hospital. As NELA Local Administrator and Local Leads, you will have the responsibility to complete the form and this may require input from your colleagues.

To see an example of questions that you might expect, and to download a copy of the results from our 2014 Organisational Audit, please go to our website. Please note, the dates and content information will be signposted in the near future.

NELA Feedback Survey

We recognise that inputting data into the NELA Database can be a burden on your team, but your work has contributed to a drop in mortality rates of patients who died within 30 days of having an emergency laparotomy. In order to make the Audit less of a burden, we would like you to complete a brief Feedback Survey telling us what you like, what you don't like, and where we can improve. Not all survey questions need to be answered, so please feel free to respond only to those that you feel are applicable to you.

We very much appreciate that your time is already stretched quite thin and that the last thing you need is an additional form to fill out. If you are able however to find some spare time over the next month to complete the survey we would greatly appreciate it. We will be sending out an email with the link to the Survey, but you can also find it here.

Second NELA Patient Report Publication

We are also delighted to announce the Second NELA Patient Report was released on Tuesday, 5th July 2016. The members of the NELA Project Team have spent the last few months working hard on analysing the over 23,000 patient cases that were collected during Year 2 of the Patient Audit. This brings the total number of patients in the Audit to over 55,000 people.

The Year 2 report includes risk-adjusted mortality data, hospital specific process and outcome measures, and explanations on how processes have changed from Year 1 to Year 2.

You can access the Patient Report, as well as the Standalone RAG table and our technical documents, on the Reports page of our website.

Patient Data Collection

Data collection and data entry continues as we are now into the 10th month of Year 3 of the patient audit. The Project Team are pleased with the ongoing hospital participation and would like to thank all those who are contributing to the audit.

You will 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.

A number of participating hospitals are unfortunately still falling slightly behind on the data collection and entry process, with a portion of qualifying procedures not making their way onto the database. We would like for you to remember that NELA is an ongoing audit. 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 and locked.

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 to contact the NELA Helpdesk.

Quality Improvement Dashboard

Have you taken advantage of the Quality Improvement Dashboard available on our web tool yet? The Dashboard is the easiest way to see how you have been performing on key process measures and how that performance compares to the national average.

Using the date-range function to isolate Year 2 or Year 3 results, you can get an idea of what to expect from the upcoming Patient Audit Report. Specifically, you can gather 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

Upcoming Events Featuring NELA Speakers (November)

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

"PATIENT FIRST - Preventing Harm, Improving Care" November 22-23 ExCeL, London

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.

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

•December 2014: 2nd year of data collection for patient audit commenced
•June 2015: First Patient Report published
•December 2015: 3rd year of data collection for patient audit commenced
•July 2016: Second Patient Report published
October 2016: Data collection for Second Organisational Audit
•December 2016: 4th year of data collection for patient audit commenced

Contact info:

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