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NELA and the EPOCH Trial collaboration

NELA and the EPOCH Trial collaboration

EPOCH is a randomised stepped wedge cluster trial of a quality improvement intervention to implement an integrated care pathway in patients scheduled for emergency laparotomy surgery. It will involve ninety NHS hospitals which will be organised geographically into fifteen groups or 'clusters' of six. The trial will take place over an 85-week period starting in Spring 2014 and we estimate data will be collected on around 27,000 patients during this time. The EPOCH trial will be run in tandem with NHS National Emergency Laparotomy Audit (NELA) for the purposes of data collection. This co-operation is supported by HQIP, and will minimise the time commitment for investigators in individual hospitals and maximise the benefit of the two projects.

As the trial intervention is at an institutional level, individual patient consent will not be required. Data will be captured by the direct care team through NELA and then anonymised before transfer to the EPOCH team. There is no additional data collection required by the direct care team for EPOCH over and above that required for NELA. Hospitals not participating in EPOCH will be totally unaffected.

We are working very closely with the NELA team to capture high quality data whilst minimising the demands placed on investigators' time. It is important to mention that all hospitals must collect data for NELA from the very start of the trial even if they have not started the quality improvement project. After hospital discharge, long-term follow up will be performed by NELA using national registries.

The trial has secured funding from the NIHR Health Services and Delivery Research panel. If you have any questions about the EPOCH Trial please contact Kirsty Everingham (Trial Manager) or Prof Rupert Pearse (Chief Investigator)