Delivering a national QIP for Patients with AAA

VASCUNET 2008

The 2008 report from the European Registry Group compared outcomes between European countries in key vascular procedures.

The reported mortality for AAA repair was 7.5% in the UK compared to an European average nearer 3.5%.

The UK was clearly identified as an outlier for mortality after elective repair of Abdominal Aortic Aneurysm (AAA).

ESVS Vascular Surgery Database Report 2008

Develpment of the QIP (2009)

The VASCUNET report prompted a period of reflection by the UK vascular surgical community and the recognition of the need for improvement. A quality improvement framework was developed by the VSGBI in 2009. This identified core standards for care delivery and service organisation, and set a target to reduce mortality after elective repair to 3.5% or less by 2013.

In late 2009, the Vascular Society was successful in obtaining a grant from the Health Foundation to run a national programme with the aim of reducing elective AAA mortality and implementing best practice.

The grant award allowed the formation of a team to deliver a National Quality Improvement Programme (AAA QIP).

At the outset it was realised that local ownership of the programme would be the key to success, and a regional approach was adopted.
Delivery of the AAAQIP involved joint collaboration from the Vascular Anaesthesia Society, the British Society of Interventional Radiology, the Society of Vascular Nurses, local Cardiac and Stroke Networks, Commissioners and significant patient input both through focus groups and as influencing voices in regional meetings.

The reports below provides details of how the AAAQIP was delivered, describes key findings and makes recommendations for future practice within the UK. It should be read by clinical teams, managers and commissioners.

National AAA QIP Interim Report 2011

Delivering a National QIP for Patients with AAA (2012)

First UK AAA report

The first Vascular Society public outcome report for elective Abdominal Aortic Aneurysm (AAA) surgery in the United Kingdom was published in March 2012. The report contains information about unit outcomes for elective AAA repair between October 2008 and September 2010.

Data on outcomes is derived from surgeon collected data held on the Vascular Society’s National Vascular Database (NVD).
The reported data is unadjusted for case-mix. This should be born in mind when comparing outcomes between units.
Cases included are those discharged from hospital or who died after AAA repair between these two dates.

The report demonstrated a significant improvement in outcomes with the published mortality being 2.4% in 8380 cases of AAA surgery.

Outcomes after Elective Repair of Infra-renal AAA 2012

Second UK AAA Report

The second report on outcomes following elective infra-renal abdominal aortic aneurysm (AAA) surgery in the United Kingdom, and includes over 13,000 operations performed between January 2010 and December 2012.

Data from all UK NHS acute trusts and Health Boards currently providing AAA surgery: