Abstract Aim Frailty is a key predictor of poor outcomes in emergency laparotomy (EmLap) patients. The National Emergency Laparotomy Audit (NELA) recommends pre-operative frailty assessment for all patients aged ≥ 65years. This quality improvement project aimed to evaluate and improve frailty assessment and documentation rates in a tertiary teaching hospital. Methods Retrospectively collected data from consecutive EmLap patients as per NELA criteria between August to October 2024 from a single centre was analysed. Patients aged ≥ 65 years were included. Frailty was assessed using the Rockwood Clinical Frailty Scale (CFS). The results were presented at departmental meeting, and educational posters were displayed in wards. The study was repeated from December 2024 to January 2025 to assess the impact of these interventions. Results In the initial audit, 20 (40%) eligible EmLap patients were included. Median age was 69 years, 55% being female. CFS documentation was recorded in 5% of cases pre-operatively. Following the interventions, 13 (40.6%) eligible patients were included in the second audit with median age of 74 years with 46% female. CFS documentation improved to 30.8% pre-operatively. Conclusion Despite the established impact of frailty on EmLap outcomes, frailty assessment remains suboptimal. Targeted interventions such as education and visual prompts resulted in modest improvements, highlighting the potential for simple measures to drive practice change. Further efforts are required to embed routine frailty assessment into clinical workflows to optimise patient outcomes.
Yeow et al. (Fri,) studied this question.