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