1. Developing a structured narrative with an improvement message Jose Lourtie NELA Project Manager Royal College of Anaesthetists

2. OR

3. NATIONAL EMERGENCY LAPAROTOMY AUDIT WHAT IS A LAPAROTOMY:

4. NATIONAL EMERGENCY LAPAROTOMY AUDIT OVERVIEW / BACKGROUND:  Project started in December 2012  100% of eligible Hospitals registered  Over 45,000 individual patient cases entered in first two years of patient audit  6,000 users registered online and entering data  Carried out by the National Institute of Academic Anaesthesia's (NIAA) Health Services Research Centre (HSRC) on behalf of the Royal College of Anaesthetists  Being run alongside other key stakeholders (eg Royal College of Surgeons)

5. NATIONAL EMERGENCY LAPAROTOMY AUDIT WHY IT WAS COMMISSIONED & AIMS:  30,000 Laparotomies undertaken each year  Research showed evidence that too many people die undergoing Emergency Laparotomies  Wide variation in care  15% mortality rate  Overall aim is to improve quality of care for patients undergoing Emergency Laparotomy

6. NATIONAL EMERGENCY LAPAROTOMY AUDIT REPORT INPUT:  Clinical Reference Group  Project Team  HQIP  NHS England

7. NATIONAL EMERGENCY LAPAROTOMY AUDIT PUBLICATIONS:  Organisational Audit  Patient Audit

8. Exec summary: – Key Themes – Recommendations – Findings NATIONAL EMERGENCY LAPAROTOMY AUDIT PATIENT AUDIT REPORT:

9. Full Report: – How to read report – Standards – Measures – Findings – Audit Questions – Recommendations – RAG Table – Patient Story

10. NATIONAL EMERGENCY LAPAROTOMY AUDIT PATIENT AUDIT REPORT: Full Report: – How to read report

11. NATIONAL EMERGENCY LAPAROTOMY AUDIT PATIENT AUDIT REPORT: Full Report: – Overall Recommendations Commissioners Chief Executives Medical and Clinical Directors Multidisciplinary teams NELA Leads

12. NATIONAL EMERGENCY LAPAROTOMY AUDIT PATIENT AUDIT REPORT: Full Report: – Standards – Findings – Audit Questions – Specific Recommendations – Best Practice

13. NATIONAL EMERGENCY LAPAROTOMY AUDIT PATIENT AUDIT REPORT: Full Report: – RAG Table – Individual Hospital Results

14. NATIONAL EMERGENCY LAPAROTOMY AUDIT PATIENT AUDIT REPORT: Full Report: – Patient Story

15. NATIONAL EMERGENCY LAPAROTOMY AUDIT PATIENT AUDIT REPORT: Post Report and Ongoing Support – Hospital Action Plans – Template PowerPoint presentation – Dashboard

16. NATIONAL EMERGENCY LAPAROTOMY AUDIT NELA DASHBOARD:  New Quality Improvement initiative being developed  Provides real-time feedback of local data in comparison to National  Allows for data to be easily viewed and interpreted  Demographics & Case Ascertainment  key QI indicators  Export own data

17. ANY QUESTIONS? More information at: NELA.ORG.UK Follow us on: @NELANews Email: jlourtie@rcoa.ac.uk