Emergency laparotomy is a major surgical procedure, with around 50,000 operations performed annually in the UK. It is a high-risk procedure, with an overall 30 day mortality rate of 10 per cent, rising to 24 per cent for those over 80 years of age. It is also a costly procedure, with over 25 per cent of patients remaining in hospital for more than 20 days after surgery, costing the NHS over £200 million per year in care.
Evidence shows that the use of an evidence-based care bundle can reduce average length of stay and mortality rate for patients undergoing emergency laparotomy surgery.
Emergency laparotomy in the North West of England
The Academic Health Science Networks (AHSNs) have been asked by NHS England and NHS Improvement to support the spread and adoption of the Emergency Laparotomy Pathway Quality Improvement Care bundle to help improve standards of care for patients undergoing emergency laparotomy.
The Innovation Agency, the AHSN for the North West Coast, is supporting this quality improvement project locally.
We have invited the National Emergency Laparotomy Audit (NELA) leads from acute trusts across the North West to engage in a clinical network, the North West Emergency Laparotomy Collaborative (NWELC), which will encourage a culture of collaboration and provide the opportunity for identifying system priorities and shared learning. The NWELC network will create a safe space in which clinicians can learn from each other to define what works and why, cutting through hierarchy and bureaucracy and rapidly spreading improvements in care and innovation.
NELA has prepared some Best Practice Tariff Frequently Asked Questions which can be viewed here...
We aim to support hospitals to improve Emergency Laparotomy care through use of the ELC care bundle. Resources, such as an ELC run-chart maker, are available to demonstrate improvement and we also intend to distribute a comparative dashboard showing adherence to the ELC care bundle and patient outcome measures on a quarterly basis. Hospital teams participating in the programme can then use this data to improve quality of care and patient outcomes on an ongoing basis. Trusts could also share their progress at collaborative learning events enabling open dialogue, group reflection and celebration of success.