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TERJE JANSSON TIMAN
Dissertation Defense: November 24, 2023 (click for details)
Doctoral Thesis:
Research Area: Surgery
Sahlgrenska Academy, The Institute of Clinical 91̽��s

Perforation or obstruction in the intestines, or intra-abdominal bleeding – these are common reasons why patients need to undergo acute major abdominal surgery.

“These patients face high mortality rates and often experience complications. This situation results in immense suffering for the patients and their families,” says Terje Jansson Timan, a specialist in anesthesiology and intensive care at Norra Älvsborg County Hospital (NÄL) in Trollhättan, western Sweden.

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A study of 1,300 patients

In Denmark and England, the care for this patient group has been improved by a standardized approach in their management. Inspired by these developments, Terje Jansson Timan and his colleagues in Trollhättan devised a similar systematic approach.

“My doctoral project is about how we’ve tried to enhance patient care by implementing a more systematic and standardized approach for the healthcare teams. Our study involved over 1,300 patients.”

Reduced ICU stay

What are the most crucial research findings?
“The study demonstrates that mortality decreased by over 25 percent when healthcare teams adopted the systematic standardized care. Additionally, this approach enables earlier hospital discharge for patients and reduces the need for extended stays in the intensive care unit.”

What has been enjoyable and challenging about this doctoral project?
“This is, in a way, a management study. Initially, it was quite a challenge to make the new approach work, ensuring that everyone would use the systematic standardized clinical protocol when caring for these patients,” says Terje Jansson Timan, and he adds:

“It was gratifying to see that we could implement this. Later on, it was incredibly satisfying to discover that it seems to have greatly improved the outcomes for our patients.”

More hospitals follow

Do you know if other hospitals in Sweden are adopting similar approaches to care for emergency patients needing major abdominal surgery?
“Alongside our study, international guidelines with strong recommendations for standardized care have been published this year. I’m aware that several Swedish hospitals are currently in the process of implementing protocol-based standardized care for these patients, and that’s a positive development. However, there is still much work to be done for all Swedish emergency hospitals to follow the new international guidelines.”

How are you working to spread this knowledge, given the success of the approach?
“We maintain close contact with several hospitals across Sweden that are either in the initial phases of implementation or seeking insights into our experience with introducing protocol-based standardized care. Additionally, our study has been presented at numerous national and international conferences.”

Text: Jakob Lundberg