TPW 5.07 A Preliminary Decision Making Model for Patients Requiring a Potential Emergency Laparotomy
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ID: 323890
2026
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Abstract
Abstract Background The decision to undergo an emergency laparotomy (EL) is important; EL is associated with high mortality, morbidity, loss of quality of life and reduction in patient independence. Research into decision-making prior to potential EL has been largely surgeon centric and ignored the voice of the patient. An understanding of context specific decision-making practice and pathways is required in order to improve patient involvement in these decisions. Methods Three weeks of observational ethnography were undertaken by a single researcher with clinical experience in the context of emergency laparotomy. The researcher was embedded within the acute surgical teams at three varied acute hospital sites in the United Kingdom. Decision making conversations between patients, family members and healthcare professionals were audio recorded and fieldnotes were taken. A preliminary decision-making model was subsequently designed to describe how decisions are made in this context. Results A decision-making model was created to reflect the different potential pathways prior to a possible EL. This was generated from observation of practice as part of the embedded ethnographic word completed in this context. This model involved three different stages which included patient identification, understanding the indication for an EL and finally understanding the chance of an acceptable outcome. This model included the influence of patients and different members of the healthcare multi-disciplinary team. Discussion A preliminary model has been developed to understand the process of decision making prior to a potential EL. Further qualitative analysis of decision-making conversation transcripts and field notes will inform development of this model.
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openalex_W7172525727
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| Authors | Samuel Lawday, Leila Rooshenas, Jane Blazeby, Tim Stephens, Angus McNair |
| Journal | the british journal of surgery |
| Year | 2026 |
| DOI |
10.1093/bjs/znag087.349
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| URL | |
| Keywords | Keywords not found |
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