# Emergency Laparotomy Risk Assessment: A Qualitative Study of General Surgeons and Trainees

## TL;DR

This study explores why general surgeons and trainees do not use risk assessment tools for emergency laparotomies, identifying barriers and potential solutions.

## Contribution

The study provides new insights into surgeon attitudes and practical barriers to using risk assessment tools in emergency surgery.

## Key findings

- Barriers to tool use include perceived lack of utility and hospital culture.
- Strategies like education and integration with electronic health records were suggested to improve uptake.
- Low adoption of risk assessment tools persists despite recommendations for universal use.

## Abstract

General surgeons perform emergency laparotomies on a heterogeneous patient population. Scoring tools have been developed to quantify the risk of mortality after EL, but the uptake of these tools is poor. We aimed to characterise the attitudes of surgeons to risk assessment tools.

Australia.

General surgeons, registrars and residents.

Semi‐structured interviews with participants, analysed using Framework Method.

Fifteen participants were interviewed. Barriers identified included perceived lack of utility, competing priorities, unit or hospital culture, individual surgeon attitudes, lack of funding, junior medical staff turnover, and lack of familiarity. Potential strategies for improvement identified included education, integration with electronic health records, and prompting at time of theatre booking.

Our findings will be of interest to those undertaking quality improvement work with risk assessment. This is important given recommendations for universal risk assessment but the low uptake of risk assessment in practice.