Emergency Laparotomy

National Overview

The programme involves the spread and adoption of the evidence-based Emergency Laparotomy Pathway Quality Improvement Care (ELPQuiC) bundle within NHS Trusts. By following the ELPQuiC pathway, research suggests that the patient mortality rate will decrease and the recovery period in hospital reduces following an Emergency Laparotomy.

Programme Aims

The ELPQuiC bundle is evidence based and contains 6 elements:

  1. Early identification of patients who pose the most risk of deterioration
  2. Sepsis screening and early implementation of antibiotics for patients
  3. Prompt diagnosis and surgery with 6 hours for the patient
  4. Consultant delivered care throughout surgery
  5. Fluid optimisation during surgery and critical care
  6. Post operative intensive care for all.

Delivery across the NENC

The AHSN NENC is committed to refining the quality improvement methodology of care for patients within our locality and delivering sustained engagement with clinical networks, all trusts within the NENC are engaged with the pathways.

The AHSN NENC has recruited two clinical leads to take this project forward in the region; Dave Saunders is an Anaesthetist and the National Emergency Laparotomy Audit (NELA)  lead at The Newcastle upon Tyne Hospitals NHS Foundation Trust (NuTH), and Ben Griffiths, who is a Colorectal Surgeon, also based at NuTH.  Ben is also the Regional lead for this project and represents NENC at a national level.

After an initial engagement with the NELA leads in all the Trusts across NENC in January 2019, we agreed to work together to develop the pathways that meet the requirements of the national aims and are fit for purpose to meet the requirements of the Best Practice Tariff for EmLap that came in to effect on 1st April 2019.  At the second event in March 2019, and after contacting all of the NHS Acute Trust Medical Directors and Chief Executive Officers regionally, it was agreed that these pathways be adopted and implemented.  These documents have now been finalized and circulated to the Trusts for adoption, the latest versions can be found below:

Adult with abdominal pain Pathway

Emergency Laparotomy Pathway

EmLap Newsletter

We have developed this newsletter as a mechanism for keeping in touch with the Emergency Laparotomy Community in the North East and North Cumbria in between meetings.  All the latest editions can be found by following the links below:

For more information about the programme in the NENC area please contact Liz Brown.

View the presentations from our July 2019 EmLap regional meeting.

View the presentations from our March 2019 EmLap regional meeting.

View the presentations from our January 2019 EmLap regional meeting.

For more information about the implementation of the Emergency Laparotomy Programme nationally visit The AHSN Network Atlas.