ANZ Emergency Laparotomy Audit – Quality Improvement


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Pilot audit

The surgical and anaesthesia colleges, supported by their specialised societies and sister colleges, believe there is a compelling case for a prospective Australian and New Zealand Emergency Laparotomy Audit (ANZELA) to provide data to support quality improvement activities to be undertaken in hospitals.  

This project is co-led by Royal Australasian College of Surgeons (RACS) and Australian and New Zealand College of Anaesthetists (ANZCA) with collaboration from General Surgeons Australia, New Zealand Association of General Surgeons, Australian Society of Anaesthetists, New Zealand Society of Anaesthetists, Australasian College for Emergency Medicine and College of Intensive Care Medicine.

About the audit

The pilot will work by centrally collecting data from participating hospitals on emergency laparotomies performed within their hospital. 

This data will then be used to provide regular feedback to each participating site, allowing them to assess their performance against evidence-based indicators of care, and to drive quality improvement processes across the hospital.

The audit has national ethical approval in both Australia and New Zealand, and each hospital needs to coordinate their local governance approval (and in Australia, hospitals in the Northern Territory and Tasmania who are not in the National Mutual Acceptance Scheme need to seek separate ethical approval). For assistance in local governance approval, contact the ANZELA-QI Helpdesk.

The New Zealand arm of the project is also seeking to minimise manual data collection by the clinicians. This involves the lead investigators working with participating hospitals to maximise data extraction from each hospital's electronic documents wherever possible. As it is a project-within-a-project, it is called CADENZAA - CAre DElivery in New Zealand for the Acute Abdomen.

Pilot sites

There are currently 60 hospitals (PDF 208 KB) that have nominated as pilot sites. Further expressions of interest are welcome, and should be sent to the  ANZELA-QI Helpdesk.

Data can be entered into the ANZELA-QI REDcap database once ethical approval has been received.


Overview (PPT 2.16 MB)

ANZELA-QI Process and Outputs (PDF 117 KB)

Inclusion and exclusion criteria (PDF 141 KB)

Dataset (PDF 651 KB)

Data collection form (PDF 228 KB) 

Monthly RAG Reports | calculations for numerators and denominators (PDF 128 KB)

REDCap - Getting Started in 5 Steps (PDF 193 KB)

REDCap - Creating Records in 6 Steps (PDF 209 KB) 

REDCap - Finding Records in 4 Steps (PDF 264 KB) 


The project is currently guided by a Working Party with representation from all collaborating colleges and societies. It is shortly to hand over to a Steering Committee to provide oversight to the 12 month pilot, with equivalent representation but under the direction of the Councils of RACS and ANZCA.

The audit will be operated day-to-day by the RACS Morbidity Audits Department.

Further information

RACS media release

ANZCA announcement

Related content

Article calling for a quality improvement approach for emergency laparotomy in Australia (MJA)

National Emergency Laparotomy Audit (UK)

RCS Updated Recommendations on the Perioperative Care of the High-Risk General Surgical Patient, 2018 (PDF 564 KB)


All queries please contact the ANZELA-QI Helpdesk.

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