Bakgrund: I Sverige utreds patienter med misstänkt cancer enligt Standardiserat Vårdförlopp. Det involverar många vårdgivare och professioner och kan vara en utmaning när det gäller personcentrerad vård. För patienter som utreds för matstrups- eller magsäckscancer innebär deras första SVF-besök i specialistvården en gastroskopi och mottagningsbesök. SVF-förloppet är en relativt ny vårdform och det finns inte så mycket beskrivet om patientens erfarenhet i litteraturen.   Syfte: Syftet med studien är att undersöka patienters erfarenhet av det första besöket inom den kirurgiska öppenvården hos patienter med matstrups- eller magsäckscancer inom SVF-förloppet som har en kurativ intention på deras behandling.   Metod: En kvalitativ intervjustudie med induktiv ansats genomfördes för att besvara studiens syfte. Nio intervjuer har analyserats med tematisk analys.   Resultat: Den tematiska analysen resulterade två tema, ”visshet/vetskap skapar hanterbarhet” samt ”stöd och kompetens lugnar”.   Konklusion: Många aspekter spelar roll för patientens erfarenhet av besöket. Patientens tidigare erfarenheter påverkar hur deras vård i samband med första besöket upplevs. Information ska anpassas efter patienten. Anhöriga bör inkluderas vid besöket då de kan vara en viktig resurs för patienten. Sjuksköterskan bör arbeta personcentrerat, vara stödjande och kompetent samt skapa trygghet. Specialistsjuksköterskan spelar en viktig roll genom att bedöma och handlägga komplexa omvårdnadssituationer, leda och deltaga i forskning och förbättringsarbete. / Background: In Sweden, patients with suspected Oesophageal or Gastric cancerare evaluated accordingto a dedicated care bundle named Standardized Pathways protocol that includes both medical evaluations and information from different health careproviders. The first visitat the ambulatory care includes an upper GI endoscopy performed by the upper GI surgeon and a consultation with a highly specialized team.The whole process can be a challenge for the patient when it comes to patient-centredcare. This way of directing patients with suspicion of cancer is a relatively newform of care and and there are few reports describing the patient’s experience. Purpose: The purpose of the study is to investigate patients' experience of the first visit to the surgical ambulatory care of patients with Oesophageal or Gastric cancer within the Standardized pathwaysand has a curative treatmentplan. Method: A qualitative interview study with inductive approach was conducted to answer the purpose of the study. Nine interviews were analyzed using thematic analysis. Results: The thematic analysis resulted in two themes, “knowledge makes manageability” and “support and competence calms”. Conclusion: Many aspects matter in the patient's experience of the visit. The patient's past experiences affect how they perceive their care in connection with Standardized pathways. Information should be adapted to the patient. Relatives should be included during the visit as they can be an important resource for the patient. The nurse should work patient-centred, be supportive and competent, and make the patient feelsecure. The specialist nurse plays an important role by assessing and managing complex nursing situations, leading and participating in research and improvement.

No / Emergency laparotomies in the U.K., U.S.A. and Denmark are known to have a high risk of death, with accompanying evidence of suboptimal care. The emergency laparotomy pathway quality improvement care (ELPQuiC) bundle is an evidence-based care bundle for patients undergoing emergency laparotomy, consisting of: initial assessment with early warning scores, early antibiotics, interval between decision and operation less than 6 h, goal-directed fluid therapy and postoperative intensive care. The ELPQuiC bundle was implemented in four hospitals, using locally identified strategies to assess the impact on risk-adjusted mortality. Comparison of case mix-adjusted 30-day mortality rates before and after care-bundle implementation was made using risk-adjusted cumulative sum (CUSUM) plots and a logistic regression model. Risk-adjusted CUSUM plots showed an increase in the numbers of lives saved per 100 patients treated in all hospitals, from 6.47 in the baseline interval (299 patients included) to 12.44 after implementation (427 patients included) (P < 0.001). The overall case mix-adjusted risk of death decreased from 15.6 to 9.6 per cent (risk ratio 0.614, 95 per cent c.i. 0.451 to 0.836; P = 0.002). There was an increase in the uptake of the ELPQuiC processes but no significant difference in the patient case-mix profile as determined by the mean Portsmouth Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity risk (0.197 and 0.223 before and after implementation respectively; P = 0.395). Use of the ELPQuiC bundle was associated with a significant reduction in the risk of death following emergency laparotomy. / E. LPQuiC Collaborator Group