Case Study: HIWM emergency laparotomy collaborative (ELC)

What is the HIWM ELC?

Emergency Laparotomy (known as EmLap) is a procedure used in most emergency general surgeries. It’s high-risk, with around 15% of patients reported to die within 30 days of surgery, and the care delivered is measured against key standards embedded within an EmLap pathway.

HIWM ELC supports acute Trusts to improve patient outcomes via a Quality Improvements initiative.

What were the aims of the HIWM ELC?

• To improve patient outcomes
• To minimise unnecessary variation in care and maximise delivery of time-critical interventions before, during and after procedures
• To save lives and allow more patients to return to an active and healthy life

What did we do?

The National Emergency Laparotomy Audit (NELA) is one of several National Clinical Audits mandated within the standard NHS contract. It’s of special importance because it represents the sole reporting process in identifying potential problems with the delivery of an EmLap pathway.

HIWM ELC programme has supported hospitals in optimising NELA data collection and developing their local pathway, as well as providing insight into data, feedback against key pathway standards, and ad-hoc support to individual teams.

What were the outcomes?

All 14 hospitals across the West Midlands have joined the collaborative, creating a network of expertise which includes clinician, manager and executive representatives from a wide range of stakeholder groups.

Over the first two years of the programme, participating hospitals have improved the consistency and completeness of their NELA submissions, increased the proportion of patients receiving key standards of care, reduced unnecessary variations in care, and continued to improve outcomes for patients.