Emergency Laparotomy Clinical Care Standard

What is an emergency laparotomy?

Emergency laparotomy is a high-risk, high-cost procedure associated with significant variation in outcomes, and in the way care is delivered, internationally and within Australia.^1-3 More than 15,000 Australians undergo an emergency laparotomy each year with mortality estimates ranging from 6.2%, to more than 20% in older people and people with comorbidities.^{2, 4} 

The Australia and New Zealand Emergency Laparotomy Audit – Quality Improvement (ANZELA-QI) and the UK’s National Emergency Laparotomy Audit (NELA) have identified wide inter-hospital variation in emergency laparotomy care including the use of preoperative risk assessment and frailty assessment, time to surgery, and postoperative admission to critical care and physician review for high-risk patients. Considerable variation in outcomes has also been identified including in-hospital mortality, length of stay and complication rates.^{1, 2, 5, 6} 

In leading this work, the Commission will work collaboratively with key stakeholders, and with guidance from an expert topic working group, to:

• identify and describe key evidence-based standards that will drive quality improvement in care processes and outcomes for people undergoing emergency laparotomy in Australia
• develop indicators to support local monitoring and quality improvement efforts related to the standards of care
• develop a Clinical Care Standard that enhances and supports existing efforts and initiatives to improve the quality of care and outcomes for people undergoing emergency laparotomy
• identify strategies, and develop resources, to support the dissemination and implementation of the Clinical Care Standard.
   

About the Standard

Who was consulted on the Standard’s development?

Clinicians, consumers and healthcare services will be consulted during the development of the Standard, which will include a public consultation period. The Commission has established a Topic Working Group (TWG) to provide advice and guidance throughout the development of the Standard. The TWG is a multidisciplinary group of clinicians, researchers and consumers from around Australia.

• Topic Working Group - Emergency Laparotomy Clinical Care Standard (2025)
   

Next steps

1. A high-level summary of the activities and timeframes to deliver this Clinical Care Standard are provided in the table below.
2. These timelines are subject to change.