EPOCH phase 2 qualitative evaluation
Research type
Research Study
Full title
Enhanced Peri-Operative Care for High-risk patients (EPOCH) Study: Phase 2 qualitative evaluation
IRAS ID
48038
Contact name
Graham Martin
Contact email
Sponsor organisation
University of Leicester
Research summary
Some patients in hospital undergo a procedure termed emergency laparotomy (major surgery to treat a life-threatening problem within the abdomen). Almost 9,000 of these patients will die within three months of surgery, out of 35,000 admissions.
Recent evidence shows that standards of patient care vary widely between hospitals. Guidelines have been developed which set out the important standards of care for emergency laparotomy patients. However, previous attempts to implement guidelines to improve patient care have proved challenging. Some doctors question the benefits of these initiatives and cite the lack of clinical evidence. The EPOCH study aims to provide evidence, by studying the effects of using a quality improvement (QI) intervention to introduce an ‘integrated care pathway’ on survival for emergency laparotomy patients. EPOCH is a large clinical trial aiming to confirm whether fewer patients die within 90 days of surgery in hospitals where the QI project is in place.
It is essential to ensure that the QI intervention has the best possible chance of influencing clinical practice and securing the effective implementation of the integrated care pathway. This qualitative study uses ethnographic methods (observation of and interviews with staff) to provide generalisable learning about the QI approaches used and the reasons for the success or failure of the integrated care pathway in improving outcomes, and will provide feedback to help refine it.
Six hospitals already taking part in EPOCH will be recruited at various stages of the trial, purposively sampled to represent diversity, such as hospital size, teaching status and baseline performance. Researchers will visit hospitals at various times of the day and night (up to 40 hours at each hospital) to find out about how emergency patients are cared for, and will be asking staff and patients if they would be willing to talk about their experiences. These interviews are entirely voluntary.
REC name
North West - Haydock Research Ethics Committee
REC reference
14/NW/0139
Date of REC Opinion
15 Apr 2014
REC opinion
Further Information Favourable Opinion