With a commitment to Transforming Lives Through Innovation, KSS AHSN is passionate about supporting new ways of working and delivering real change to the healthcare system. We focus on a project from our patch that is now making its presence felt on a much grander scale.
From an initial trial at Royal Surrey County Hospital NHS Foundation Trust, KSS AHSN is now leading on the national spread and adoption of the Emergency Laparotomy care bundle.
Emergency laparotomy is a common surgical procedure that carries a high risk of the patient dying within 30 days of surgery. Each year 30-50,000 operations are carried out, with over a quarter of patients remaining in hospital for more than 20 days.
Through its Emergency Laparotomy Collaborative, KSS AHSN has been instrumental in developing a care bundle that has been proven to improve outcomes, and is now being rolled out across the AHSN Network.
The journey started in 2015, when the Royal Surrey County Hospital NHS Foundation Trust developed an evidence-based emergency laparotomy care bundle.
This was rolled out across four hospitals as the ELPQuIC project. Data collected over an eight-month period found crude 30-day mortality rate for all patients was reduced by 25% and risk-adjusted hospital mortality rate reduced by 42%.
With the support of the Health Foundation, and led by KSS AHSN’s Emergency Laparotomy Collaborative, this care bundle (now known as the ELC care bundle) was implemented in 28 hospitals within three AHSN regions: Kent Surrey Sussex, West of England and Wessex, using the IHI breakthrough series methodology.
Initial results showed that the roll-out of the care bundle across 28 hospitals successfully reduced average length of stay by 1.3 days and reduced crude in-hospital 30-day mortality rate by 11%, when comparing baseline period with the improvement period.
In Kent Surrey Sussex alone, we estimate that 79 lives were saved during the 24-month programme.
The project has now been chosen by NHS E and the AHSN Network as one of seven projects to spread nationally. It is estimated that 26,500 patients will have benefited from the programme by the end of March 2020.
Jo Wookey, Senior Programme Manager at KSS AHSN, is leading the national roll out of the project.
“ELC has been a great success across the three AHSNs that ran the initial project, and we’re thrilled to now be leading on its national roll out,” she said.
“The key issue when spreading a project nationally is not to impose a hard set of rules, but to have enough flexibility within the project to ensure that it can take into account regional variations.
“Each AHSN is following the same approach in terms of collecting data, peer support and sharing learnings. However, which elements of the care bundle are delivered remain flexible, to allow for regional differences.
“Interestingly, what we’ve seen is that while the actual care bundle can look different in different locations, as the long as the collaborative principles behind it are the same, then the approach works.”