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EP.FRI.1012 One plus one equals four: how NELA inspired a quality improvement programme that produced 4 distinct positive outcomes


 
 
 To describe how NELA inspired an ‘improving emergency surgery’ quality improvement programme that produced improvements in 4 distinct areas of surgical practice.
 
 
 
 This paper describes how Kotter's improvement methodology was implemented in a district general hospital to achieve NELA targets, reduce the negative appendicectomy rate in children, implement NICE guidance on early laparoscopic cholecystectomy for acute cholecystitis and consistently deliver the 'S' and 'A' of SAFER within the surgery department.
 
 
 
 As a result of a systematic quality improvement approach,
 
 
 
 Incorporating NELA into a local 'improving emergency surgery' quality improvement programme has delivered important and wide-ranging benefits beyond emergency laparotomy, and protected the service from 'crowding out behaviour' where focus on a single quality improvement can come at the expense of quality in other areas.
