eP430 Raising Awareness of NELA and Perioperative Standards for Emergency Surgical Patients

Objectives We aimed to identify our hospital’s current rate of NELA case ascertainment, pre-operative risk assessment and geriatrician referral rates. The aim of this audit was to improve rates of case ascertainment, NELA risk scoring and geriatric referral, to improve the quality of care received by emergency surgical patients. Methods We retrospectively analysed all emergency general surgery cases performed between April-June 2024 and included only NELA-eligible cases. We evaluated the rates of NELA case ascertainment, pre-operative risk assessment and geriatrician referral rates. This was presented at the local clinical governance meeting. Posters were created and placed in the surgical handover room to raise awareness of NELA targets. Data collection was repeated for October-December 2024. Statistical analysis where performed used unpaired two sample t-test with p < 0.05 considered statistically significant. Results Between April-June, 36 eligible NELA operations were performed. 29% were logged on the NELA database, 29% had a documented pre-op risk assessment and 44% of eligible patients had geriatrician referral. Between October-December, 30 eligible NELA operations were performed. 73% were logged onto NELA, 73% had a documented pre-op risk assessment and 42% of eligible patients had referral to geriatricians. There was a significant improvement in case ascertainment and NELA risk scoring (p = 0.018). Conclusions NELA case ascertainment and pre-op assessment rates did improve post intervention with statistical significance. Geriatrician referral rates did not improve. Further collaboration with geriatricians is required to improve perioperative input for our frail, elderly surgical patients.