NELA Newsletter - 37th Edition August 2017

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

Patient Data Collection

Data collection and data entry continues as we enter the 9th month of Year 4 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.

It is important to ensure that the cases being entered are also being completed and locked. Remember a patient can only be included in the audit if their case on the web tool is locked, meaning that all cases that remain "incomplete" on the system will go to waste. One of the biggest lessons we have learned is that entering patient data is easier when done in real time, rather than having to chase patient information retrospectively, often after the patient has been discharged.

As always if there is anything the Project Team can do to assist with the data collection process, whether it be adding new users onto the web tool or answering question about the inclusion/exclusion criteria please don't hesitate to let us know.

NELA Extension Announcement

As you will have seen the National Emergency Laparotomy Audit (NELA) Project Team have announced that the audit has received funding to carry on for a further 3 years, from December 2017 to November 2020.

In the first almost 5 years of the project NELA has collected and reported on over 80,000 patient cases provided by 100% of eligible hospitals. We have published Organisational and Patient audit reports and are currently collecting data for the fourth patient audit.

The success of the audit is down to your hard work locally and that of your colleagues that everyday collect and input the data. It would not be possible to have achieved such amazing results and continued improvement in patient care without your engagement and support, therefore THANK YOU!

We hope that you can see the benefit of continuing this audit and we will be providing a more detailed plan of the 3 year extension in the coming months.

Year 3 Patient Report Publication

The publication of the results from the Year 3 patient audit has been delayed due to issues with obtaining data linkage with NHS Digital. These issues are beyond our control and we apologise for the delay and any inconvenience this may have caused. We are hopeful that the report will be published in the Autumn of this year. We will keep you up to date on any developments.

In the meantime, we encourage all sites to download their Year 4 Quarter 2 reports from the "Reports section of the NELA webtool."

Hospital Progress Reports

Every month we send out the NELA Hospital Progress List. This document provides a snapshot of a hospital's status in relation to overall case ascertainment and will show different figures from the quarterly reports.

We had hoped to have updated contemporaneous HES data for this month's progress report. Unfortunately due to circumstances beyond our control relating to obtaining NHS Digital data this has not been possible. We hope it will be available soon.

As always, we hope this list proves useful in providing you with an overview of the number of cases you have entered on the NELA web tool over the last few months, as well as how complete this data is and how the numbers compare to your expected caseload.

Spreadsheet for adding new users

We have introduced an option available to sites when you need to create large numbers of new user accounts for the NELA webtool all at once. In this situation you can send us an email to request an "additional user spreadsheet" which you can add the individual user`s details to and then return this to us when it is complete. This is an option for multiple accounts.

The designated NELA Local Administrator should perform a search of individuals to be added prior to sending us the list, to identify active members within the webtool and those not. Once we have received this information we will generate the requested log ins and send through a confirmation email upon completion of this task.

It will still be quicker and we prefer that Local Administrators continue to add new users themselves and use this option only for multiple accounts.

NELA APP & Risk-Prediction Tool

The National Emergency Laparotomy Audit (NELA) has launched a perioperative risk calculator which we have developed specifically for emergency laparotomy patients. The NELA risk calculator aims to standardise the risk calculation for emergency laparotomy patients and support clinical decision making.
You can access the Stand Alone Risk Calculator website here.
Alongside this we have also launched a NELA APP which includes the risk calculator as well as information on the NELA reports.
The App is now available to be downloaded on both Apple and Android devices using the links below:

• Android here.
• iOS - here.
• To read more about click here.

Inclusion / Exclusion Criteria Changes

The NELA Inclusion/Exclusion criteria were updated in April. If you have not had a chance to familiarise yourself with these changes please check the new criteria on our website under "FAQ's." and on the web tool . As always the criteria on the Inclusion/Exclusion list is not exhaustive. Please contact the Project Team if you have any questions or need any clarification.

Quality Improvement Videos

We have launched our third NELA Quality Improvement videos, titled "NELA: understanding the system." All three videos are listed below and can be watched on this

1. "Using run charts to drive quality improvements with NELA data"
2. "Using NELA for Quality improvement"
3. "NELA: understanding the system"

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 (new) - 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

•June 2015: First Patient Report published
•July 2016: Second Patient Report published
•1st December 2016: 4th year of data collection for patient audit commenced
Autumn 2017: Third Patient Report will be published
•November 2017: end of year 4 Audit

Contact info:

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