Jan 172019
 

13 District General Hospitals in Wales are working collaboratively with the 1000 Lives Improvement service at Public Health Wales to improve the care they provide to patients undergoing emergency laparotomy surgery (emergency bowel surgery).

This work is part of an all wales quality improvement programme called Emergency Laparotomy Cymru (ELC) launched in July 2018.

ELC focusses on a patient’s care, from the time of the individual presenting to hospital, throughout their perioperative journey and during recovery.

Hospitals are using a 6-step evidence-based care bundle approach to deliver improvements.

A data collection system known as NELA (the National Emergency Laparotomy Audit) is used, to better understand individual standards of care and use data to make improvements.

Three clinical leads have been appointed to progress the work across local regions.  Over the next few months, they will be sharing their thoughts over why this programme is so important and will discuss how it’s developing.  Each lead will be working closely with other members of a multi-disciplinary team from each hospital within their region. This will consist of staff across emergency departments, radiology, theatre, critical care and surgical wards.

 In this first blog, we speak with Dr Babu Muthuswamy, South East clinical lead. Babu is a Consultant in Anaesthesia and Intensive Care and Clinical Director for Critical Care at Aneurin Bevan University Health Board.

 In your opinion, why is ELC so important?

In Wales, a number of hospitals have good clinical pathways to improve the care and outcomes of patients undergoing emergency laparotomy but there is still variation in processes and outcomes for patients having this high-risk surgery.

ELC has been launched to support NHS Wales in improving patient outcomes across Wales. We are striving to ensure that outcomes and satisfaction levels, for patients and their wider family members, rank as some of the best in the UK.

What made you want to get involved?

I have been part of the NELA audit since its roll out 2014 and have been the lead for the Royal Gwent Hospital throughout this period. There have been numerous challenges along the way in relation to improving the processes of care to emergency laparotomy patients. Being part of a national project like this helps to raise the profile of this work and to highlight the high-risk nature of this surgical procedure. It also helps to focus the minds of multi-disciplinary teams in each hospital to work towards one aim which is improving care and patient outcomes.

 What do you hope it will achieve?

Through ELC I am hopeful that we can improve patient outcomes from:

  • Having evidence-based practice guidelines as elements of the ELC bundle;
  • Providing a support network for the NELA leads in each of the hospitals involved;
  • Improving the scope of research to refine current practice; and
  • Disseminating successful clinical pathways that have been adopted in other hospitals (across the UK).

ELC is following a UK model that has been tried and tested, having achieved successful results.

For further information:

Email:  National ELC Programme Lead:  Margaret.Rennocks@wales.gov.uk

Website:  http://www.1000livesplus.wales.nhs.uk/elc-cymru

Follow the conversation on Twitter #EmergencyLaparotomyCymru

Jan 172019
 

Mae 13 o’r Ysbytai Cyffredinol Dosbarth yng Nghymru yn cydweithio â 1000 o Fywydau – Gwasanaeth Gwella, yn Iechyd Cyhoeddus Cymru, i wella’r gofal y maen nhw’n ei ddarparu i gleifion sy’n cael llawdriniaeth laparotomi brys (llawdriniaeth brys ar y coluddyn).

Mae’r gwaith hwn yn rhan o raglen gwella ansawdd Cymru gyfan, o’r enw Laparotomi Brys Cymru (ELC), a lansiwyd ym mis Gorffennaf 2018.

Mae ELC yn canolbwyntio ar ofal cleifion, o’r cyfnod y daw’r unigolyn i’r ysbyty, trwy gydol ei daith amdriniaethol, ac yn ystod ei gyfnod gwella.

Mae ysbytai’n defnyddio ymagwedd pecyn gofal ar sail tystiolaeth 6 cham i gyflwyno gwelliannau.

Defnyddir system casglu data o’r enw NELA (Archwiliad Cenedlaethol Laparotomi Brys) i ddeall safonau gofal unigol yn well, a defnyddio data i wneud gwelliannau.

Mae tri arweinydd clinigol wedi cael eu penodi i ddatblygu’r gwaith ar draws rhanbarthau lleol. Dros y misoedd nesaf, byddan nhw’n rhannu eu meddyliau ynghylch pam mae’r rhaglen hon mor bwysig, a byddant yn trafod sut mae’n datblygu. Bydd pob arweinydd yn gweithio’n agos ag aelodau eraill o dîm amlddisgyblaeth o bob ysbyty yn eu rhanbarth. Bydd yn cynnwys staff ar draws adrannau brys, radioleg, theatr, gofal critigol, a wardiau llawfeddygol.

Yn y blog cyntaf hwn, rydym ni’n siarad â Dr Babu Muthuswamy, arweinydd clinigol y de-ddwyrain. Mae Babu yn Ymgynghorydd Anaesthesia a Gofal Dwys, a Chyfarwyddwr Clinigol ar gyfer Gofal Critigol ym Mwrdd Iechyd Prifysgol Aneurin Bevan.

 Yn eich barn chi, pam mae ELC mor bwysig?

Yng Nghymru, mae gan nifer o ysbytai lwybrau clinigol da i wella gofal a chanlyniadau cleifion sy’n cael laparotomi brys, ond mae amrywiaeth o ran prosesau a chanlyniadau cleifion sy’n cael y llawdriniaeth risg uchel hon.

Lansiwyd ELC i gefnogi GIG Cymru i wella canlyniadau cleifion ledled Cymru. Rydym ni’n ymdrechu i sicrhau bod canlyniadau a lefelau bodlonrwydd cleifion a’u haelodau teulu ehangach ymhlith y gorau yn y DU.

Pam yr oeddech chi eisiau bod yn gysylltiedig?

Rwyf wedi bod yn rhan o archwiliad NELA ers ei gyflwyno yn 2014 ac mae wedi bod yn arweinydd ar gyfer Ysbyty Brenhinol Gwent trwy gydol y cyfnod hwn. Mae nifer o heriau wedi bod ar hyd y ffordd mewn perthynas â gwella prosesau gofal i gleifion laparotomi brys. Mae bod yn rhan o brosiect cenedlaethol fel hwn yn helpu i godi proffil y gwaith hwn, ac amlygu natur risg uchel y weithdrefn lawfeddygol hon. Mae hefyd yn helpu i ffocysu meddyliau timau amlddisgyblaeth ym mhob ysbyty i weithio tuag at un nod, sef gwella gofal a chanlyniadau cleifion.

 Beth rydych chi’n gobeithio y bydd yn ei gyflawni?

Trwy ELC, rwy’n gobeithio y gallwn ni wella canlyniadau cleifion yn sgil:

  • Cael canllawiau ymarfer ar sail tystiolaeth fel elfennau o’r pecyn ELC;
  • Darparu rhwydwaith cymorth ar gyfer arweinwyr NELA ym mhob un o’r ysbytai cysylltiedig;
  • Gwella cwmpas ymchwil i fireinio ymarfer presennol; a
  • Lledaenu llwybrau clinigol llwyddiannus sydd wedi cael eu mabwysiadu mewn ysbytai eraill (ledled y DU).

Mae ELC yn dilyn model y DU sydd wedi cael ei brofi, ar ôl cyflawni canlyniadau llwyddiannus.

I gael mwy o wybodaeth:

E-bost:  Arweinydd Cenedlaethol Rhaglen ELC:  Margaret.Rennocks@wales.gov.uk

Gwefan:  http://www.1000livesplus.wales.nhs.uk/elc-cymru

Dilynwch y sgwrs ar Twitter #EmergencyLaparotomyCymru