Delivering a National Quality Improvement Programme for Patients with Abdominal Aortic Aneurysms

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The 2008 report from the European Registry Group compared outcomes between European countries in key
vascular procedures. The UK was clearly identified as an outlier for mortality after elective repair of
Abdominal Aortic Aneurysm (AAA). The reported mortality was 7.5% compared to a European average
nearer 3.5% (Vascunet 2008). This report prompted a period of reflection by the 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
(AAAQIP). 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. This report 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.