Best Practices in Critical Limb Ischaemia Care Pathways
This collection of survey results and methodologies highlights the need for consistent and evidence-based care pathways for critical limb ischaemia. Dr. Victoria Burrows and the BSIR R&A Committee provide valuable insights to address pathway delays and improve patient outcomes.
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Presentation Transcript
SNAPSHOT SURVEY 2019 CRITICAL LIMB ISCHAEMIA BSIR R&A COMMITTEE Dr Victoria Burrows MBChB FRCR ST5 IR Sheffield Teaching Hospitals
Background A Best Practice Clinical Care Pathway for Peripheral Arterial Disease March 2019 Vascular Surgery GIRFT 2018 Inconsistency across the UK Universally unacceptable pathway delays Evidence based, multidisciplinary care pathways
Method Preliminary survey Snapshot daily survey Regular reminders
Results Preliminary Survey Region Scotland and NI North East North West Y&H East Midlands West Midlands Wales East of England London South East South West
Results Preliminary Survey Hospital Hub Secondary hub Spoke No
Results Preliminary Survey Hospital Teaching DGH
Results Preliminary Survey MDT Frequency Every day Once a week Twice a week Other
Results procedures performed 9 8 7 6 5 OOH In hours 4 3 2 1 0 Mon Tue Wed Thu Fri Sat Sun
Results method of referral MDT Cons - cons Cons - reg Cons - SHO Other
Results imaging performed 12 10 8 OOH In hours 6 4 2 0 USS USS/CT USS/DSA CT MRI
Results procedures performed Inpatient Outpatient
Results Daily Survey Decision - Procedure Admit - Decision 60 50 40 30 20 10 0 1 3 5 7 9 11 13 15 17 19 21 23 25 27 29
Results delays No Room availability IR cons availability Anaesthetic availability Anticoagulation MDT Pre procedure ward issue Other
Results IP delays 7 no delay 5 room availability 3 consultant availability 2 anticoagulation 1 anaesthetic availability 1 MDT/planned around dialysis 1 specialist blood type
Results OP delays 3 no delay 2 outpatient waiting lists for stable disease 1 anticoagulation
Results operator of procedure Consultant only Registrar and Consultant Fellow and Consultant
Results presence of consultant IR IR and Vasc
Conclusions Imaging Referrals Scoring Treatment time: variable decision treatment longest median cases at or nearly at targets Delays: multifactorial consultant and room availability
Future work NVR encourage trainees to help Local audit: Cambridge Gloucestershire Hull and East Yorkshire North Bristol Royal Bournemouth and Christchurch Royal Liverpool and Broadgreen St George s The Dudley Group University Hospitals Birmingham University Hospitals of Leicester York Teaching Hospitals
Thank You BSIR R&A Committee vicky_burrows85@hotmail.com
