APAGBI Small Research Grant

The successful applicant for the APAGBI Small Research Grant was:

Children's Acute Surgical Abdomen Programme Pilot: CASAPP

Dr Ramani Moonesinghe

University College Hospital, London


Scientific Abstract
Children's emergency abdominal surgery has been highlighted as an area requiring quality assurance, improvement and research into ascertaining processes which may improve outcomes. This proposal is for a pilot research study to assess the feasibility of delivering a national quality improvement programme for this patient group. First, we will conduct an organisational survey of hospitals performing such surgery to ascertain compliance against evidence-based standards and national recommendations. The survey's quality metrics have been established through a systematic review of structure and process measures. Then, we will conduct a pilot patient study aiming to assess feasibility for a longer-term programme, develop a risk-adjustment model and validate outcome measures. We aim to recruit every UK hospital undertaking emergency abdominal surgery in children, and capture information on every child meeting our inclusion criteria. We will run this project for at least 6 months and until at least 1,500 patients are recruited. To avoid sampling bias we will apply for Section 251 exemption in England & Wales and Public and Patient Privacy panel approval in Scotland to collect patient identifiable data without consent, but where feasible parents and children will be provided with the opportunity to opt out. We will collect data on patient risk factors, compliance with process quality indicators and measure patient-centred outcomes including complications, quality of recovery and health-related quality of life. Once completed we hope to have confirmed feasibility of our approach to consent/opt out, achieved >80% participation from eligible NHS hospitals, validated our outcome measures and developed important learning to support the development of a longer-term programme. Our team has run similar projects including the National Emergency Laparotomy Audit and the Sprint National Anaesthesia Projects, and has extensive experience in health services research, paediatric research, clinical and academic leadership. Our project team has representatives from surgery, anaesthesia, the public and trainees who will be instrumental in delivering this project.