Emergency laparotomy is relatively common, high risk surgery which is carried out on between 30-50,000 cases annually in England. An evidence-based bundle of interventions and measures was initially developed by the Royal Surrey County Hospital to reduce mortality, length of stay and complications. The Emergency Laparotomy Collaborative has since spread and now covers the whole country – it is one of seven national programmes for spread and adoption coordinated through all 15 AHSNs and championed by staff at each acute hospital trust.
What is the aim of the Emergency Laparotomy Collaborative?
The aim is to reduce variation in outcomes, quality of care and metrics through the adoption of six best practice care interventions which are associated with reduced mortality and length of stay. Priorities include embedding quality improvement skills, supporting sustainable change and encouraging a collaborative culture. Key national datasets are being collated through the National Emergency Laparotomy Audit (NELA). NELA metrics provide the evidence-base to enable:
identification of areas for improvement
evaluation of the success or otherwise of new ways of working
activities supporting sustainable change.
The Thames Valley Emergency Laparotomy Collaborative brings together multi-disciplinary teams from the five acute NHS trusts performing emergency laparotomy surgery covered by the Oxford AHSN. Quarterly regional meetings coordinated by the Oxford AHSN began in December 2018. The fifth of these took place in December 2019.