emergency laparotomy collaborative...replace p-possum scoring with nela risk score in booking...
TRANSCRIPT
Emergency Laparotomy Collaborative
13th March 2019
Russells Hall Hospital Case ascertainment and locking
Dr Jenny Wright
SOARTM
Strengths Within our trust
Strong anaesthetic leadership NELA
Job planned time
Named anaesthetic NELA trainee lead
Named surgical lead (job planned)
Senior management (clinical and General Mx) engagement and support for NELA/EmLap
Regular reporting at governance meetings
Admin support and successful business case for elderly care
Strengths Awareness High awareness in Trust of NELA/EmLap
NELA included in trainee induction surgeons and anaesthetists
Log-ins for all
Risk scoring at electronic booking (P-POSSUM)
Regular emails – follow up missing/incomplete cases – NELA ‘Naughty Step’
Newsletter - quarterly
Audit presentations – use of data encourages better input
Newsletter
Newsletter
NELA Star Award
Strengths Data capture EmLap/NELA section on WHO form
Surveillance of data input for accuracy & feedback
Data input – trainees shown method in theatre
EPR used for time of arrival ED/hospital/ward stays
Theatre database – used for time of booking, anaes room entry, returns to theatre
Elderly care email + completion of NELA
WHO Checklist EmLap Section
Use PAS and EPR to source info
Use PAS and EPR to source info
Use PAS and EPR to source info
Strengths EmLap Pathway EmLap pathway – access to EmLap CT and Cons reporting within EPR
Emlap booking form for risk scoring (currently P-POSSUM score)
Time to breach countdown on booking
Theatre Booking
Opportunities Encourage further surgical engagement
Introduce a formal ‘NELA time’ with WHO sign-out to improve data accuracy and completeness
Engage theatre nurses – setting up lead nurse role
Automatic email generation for elderly care
Replace P-POSSUM scoring with NELA risk score in booking process
Secretarial/Admin support for NELA/EmLap - improve section 7 and time to locking of cases
New EPR coming with more EmLap elements incorporated
Aspirations Improved and quicker locking of cases
Every surgeon, anaesthetist and all theatre staff engaged with accurate, in-theatre data entry
Best Practice Tariff achieved
Better understanding of urgency and improved accuracy of booking to improve decision to theatre times
Improved Elderly Care input
Perioperative input by Intensive Care Consultant if risk of death>10%
Accurate and timely feedback to staff to enable further QI
Results/Resources 100% case ascertainment
Excellent Critical Care bed availability
Time in NELA Leads’ job plans
Adjusted mortality rate 8.4%
Any questions?
The End