Dr. Dave MURRAY
Consultant Anaesthetist & Chair, National Emergency Laparotomy Audit, James Cook University Hospital, United Kingdom
Dr Dave Murray has been a consultant colorectal anaesthetist at James Cook University Hospital in Middlesbrough since 2003. He established the NHS Emergency Laparotomy Network in 2010. He led the development of the National Emergency Laparotomy Audit (NELA) as National Clinical Lead 2012-2017, and is now Project Chair.
He has been a member of the National Institute of Academic Anaesthesia Health Services Research Centre management board since 2010, and a steering committee member for two NIHR portfolio trials in Emergency Laparotomy.
He has a long-held interest in patient safety and Human Factors. He was Associate Dean & Human Factors Faculty Lead for Health Education England North East (2014-2020), and a founding member of the Clinical Human Factors Group. He also has a Masters in Medical Education.
He also competes in triathlons, and has represented Great Britain within his Age Group at European and World Duathlon and Triathlon Championships.
The NHS National Emergency Laparotomy Audit has been collecting patient level data since December 2013, and now has information on delivery of care and outcomes on around 150,000 patients. Mortality has improved by ~30%, accompanied by improvements in the quality of care that patients receive. The number of patients who now receive a formal pre-operative assessment of risk has risen from ~55% to 90%. Although established as an “audit”, NELA delivers both Quality Assurance and Quality Improvement, and also provides a large database that can be interrogated for research purposes. My talk will cover all three areas.
One of the limitations of national audits is that a lot of effort goes into collecting data, sometimes without any tangible benefit for local participants who have spent considerable time and effort collecting the data. By the time the national report is published, over a year has elapsed since the initial data was provided. It’s likely that very few people read the full report! The impact of national audits reports is hence limited, as evidenced by the fact that the same recommendations are often repeated over many years.
With this in mind, NELA set out to ensure data is easily available for local quality improvement projects. We have achieved this by ensuring that data is available to clinicians and managers on a real-time basis. NELA incorporates real-time data analysis into the data collection tool, so that as clinicians enter data, online dashboards instantly update to provide real-time information on processes of care and risk adjusted outcomes. This approach also keeps clinicians interested, as they can easily see the impact of changes to their service.
The NELA dataset also provides an unparalleled resource on which to base research. My talk will also provide an overview of these research endeavours.