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Recruiting
Systems and culture
Improving the timeliness of emergency laparotomy
Background
More than 22,000 adults in England and Wales have major emergency 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.
Though many aspects of care have improved over the years, the time taken for emergency patients to get to the operating theatre has not improved. In many areas, time to surgery does not meet the recommended standards. Some hospitals are able to 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 and getting to the operating theatre for an emergency laparotomy.
Key to this project will be the creation of a community of stakeholders, with professional or personal experience of the pathway from emergency department to theatre. This community will be based on a dedicated online platform called Thiscovery and will help us to gain insight into the potential causes of delays and develop possible solutions.
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, carers and family members. We will also bring in people who are specialists in the design of systems.
Promising solutions will be tested in hospitals to see if they improve the time that patients have to wait for their operation. The project team will use the information from the National Emergency Laparotomy Audit to see if the potential solutions have made a difference to the time it takes for patients to have their surgery. The project team will also review this whole approach, to see if it could also help with other problems in healthcare.
We’re currently looking for healthcare professionals experienced in working on the emergency laparotomy pathway to join our online community.
Project team
Lorna Jacobs
Funding and ethics
This project is funded by the Health Foundation’s grant to The Healthcare Improvement Studies Institute (THIS Institute). It is independently led by THIS Institute and the Royal College of Anaesthetists, in collaboration with the National Emergency Laparotomy Audit (NELA).