A leading bowel surgery quality improvement initiative led by the Royal College of Anaesthetists (RCoA) has been extended for a further three years.
The National Emergency Laparotomy Audit (NELA) is designed to improve patient outcomes following emergency bowel surgery. It is commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the high profile National Clinical Audit Programme and supported by the Royal College of Surgeons of England.
More than 30,000 patients undergo emergency bowel surgery (emergency laparotomies) every year in the United Kingdom. NELA aims to enable the improvement of the quality of care for patients undergoing this emergency surgery. With a mortality rate of more than 11%, more patients die from this procedure than from any type of planned high-risk surgery.
Since NELA was established in 2014, more than 80,000 patient records have been collected and studied. NELA allows hospitals to see their own variation in comparison to others by providing data in real time leading to year-on-year improvement in the number of hospitals delivering the highest quality of care for emergency laparotomy patients.
Since local clinical teams have been able to access the NELA data and improvement tools, the average length of stay in hospital for emergency laparotomy patients has been reduced by 1.8 days with estimated annual cost savings of more than £22 million for UK hospitals. Mortality rates have dropped from 11.7% to 11.1% over the same time period, saving hundreds of lives.
Dr Liam Brennan, president of the Royal College of Anaesthetists, said: “NELA is an excellent example of where working closely with our surgical colleagues and HQIP is resulting in real clinical improvements in hospitals across England and Wales. With anaesthetists responsible for caring for patients before, during, and after surgery, we are able to focus not only on what happens in the operating theatre, but also on the impact of actions before and after surgery. We are pleased to be continuing our work with HQIP to improve care and help save hundreds of lives every year.”
Sir Bruce Keogh, national medical director at NHS England, said: “We cannot improve our services unless we know what we are doing well and what we are doing less well. This audit is a template for how quality improvement led by hospital doctors can deliver improved patient outcomes within the NHS. This initiative demonstrates that better quality care, shorter stays in hospital and cost-savings for the hospital itself are not mutually exclusive. It adds to the evidence that better care costs less.”
