950 Successful Relaunching of NELA at an Inner-City District General Hospital: Need for Multidisciplinary Approach. (19th August 2022)

• Record Type: Journal Article
• Authors: Sarodaya, V; Gohil, B; White, A; Garg, A
• Is Part Of: British journal of surgery. Volume 109(2022)Supplement 6
• Publication Date: 2022-08-19
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1093/bjs/znac269.215
• Languages: English
• ISSNs: 0007-1323

Abstract

Abstract: Introduction: The national case ascertainment rate for National Emergency Laparotomy Audit (NELA) over 179 hospitals is 84.5%. Our hospital is one of the few hospitals despite being eligible, had not submitted any data to the NELA for the past three years. Method: We retrospectively collected data for all the patients that underwent laparotomy for a period of 2 years. The mean age of patients was 58 years. We found 83 patients who fit NELA inclusion criteria from January 2020 to November 2021. Results: The 83 patients were divided into low risk (<5%) and high risk (>5%) and further analysed. The overall mortality was higher than the national (24% v/s 9.3%). Areas of excellent performance against NELA standards (i.e., > 80% compliance) included Consultant's involvement in theatres, Surgeons in 96.9% cases and Anaesthetist in 88.9% cases compared to National average of 96.9% and 93.9% respectively. Areas with poor compliance were Geriatrics involvement pre-operatively (14.7%) when compared to national average (24.7%). Pre-op assessment was done in 48% cases approximately half of national average of 84%. Post operatively 81.4% of the high-risk patients were directly admitted to ITU which was the same as the national average of 85%. Conclusion: There were various factors which resulted in a low compliance rate. NELA is a useful audit for the comparison of national care. It allows for reflective practice at local level with aim to deliver a uniform standard of care.