Improving the timeliness of emergency laparotomy
Background
Over 22,000 adults in England and Wales have emergency major abdominal surgery involving a surgical incision into the abdominal cavity (known as a laparotomy) each year. When someone needs a laparotomy, it is important that they are treated as soon as possible because delays can increase the likelihood of a long hospital stay or death. Despite many aspects of care having recently improved, the time taken for emergency patients to get to the operating theatre has not improved and, in many areas, time to surgery does not meet the recommended standards. Hospitals show a lot of variability in timeliness – some can get patients to theatre much faster than others, but how they are achieving this and whether others can do the same remains unclear.
Approach
This project aims to find ways to improve timeliness between arrival at an emergency department needing surgery and getting to the operating theatre for an emergency laparotomy. We will capture the perspectives of a range of people involved in the pathway to a laparotomy, including those who work in emergency care, in surgery, and in tests and imaging, as well as patients and carers, as well as specialists in the design of systems. Key to this project will be the creation of a community of stakeholders, with professional or personal experiences of the pathway from emergency department to theatre. The community will be based on the dedicated online platform Thiscovery, and will build an understanding of what might be causing delays.
Promising solutions developed through this process will be tested in hospitals to see if they improve how quickly patients have their operation. Information from the National Emergency Laparotomy Audit will also be used to see if the potential solutions have made a difference to the time it takes for patients to have their surgery.