AB099. SOH22ABS157. “Details create the big picture”: use of a national audit database to identify areas for improvement in major vascular surgical patients
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AB099. SOH22ABS157. “Details create the big picture”: use of a national audit database to identify areas for improvement in major vascular surgical patients

Andrew Cummiskey1, Mary Barry2, Joseph Dowdall2, Andrea Haren1, Amy Donnelly1, Abigail Walsh1, Hilary Hurley2

1Department of Anaesthesia and Peri-operative Medicine, St. Vincent’s University Hospital, Dublin, Ireland; 2Department of Vascular Surgery, St. Vincent’s University Hospital, Dublin, Ireland

Background: National Quality Assurance Information System (NQAIS) is an electronic database that captures inpatient data from publicly funded Irish hospitals. At 18.1 days, the average length of stay at St. Vincent’s University Hospital (SVUH) for patients undergoing major vascular surgery (abdominal aortic aneurysm repair and lower limb revascularisation surgery) was above the national target of 11.8 days. Goals: Benchmark length of stay. Describe this cohort’s perioperative course. Propose quality improvement project.

Methods: Patients who underwent major vascular surgery at SVUH between January-July 2021 were selected for retrospective audit because NQAIS data suggests length of stay is above national averages. Patients (n=35) were identified through theatre lists. Audit approval obtained. Data collected from patient notes using excel.

Results: Cohort age (years): mean 70, median 71, range, 52–88.85% underwent anaesthetist pre-operative assessment in keeping with a national standard of 80%. Pre-operative V-Possum Score for elective patients: mean morbidity 59%, median 56%, mean mortality 7.6%, median 5.3%. Total length of stay (days): mean 18.7, median 16. Post-operative length of stay (days): mean 9.1, median 8. Most patients required at least one referral to a sub-specialty while in hospital. One third referred to cardiology.

Conclusions: NQAIS data generates national averages. This study suggests length of stay is heavily skewed by a long pre-operative course with many patients requiring intervention from medical specialties postoperatively. Detailed hospital audits can identify quality improvement areas. Proposal: Review and management by relevant sub-specialties in the pre-operative period, ideally in an ambulatory pre-operative assessment clinic.

Keywords: Audit; vascular; benchmark; quality; improvement

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-22-ab099
Cite this abstract as: Cummiskey A, Barry M, Dowdall J, Haren A, Donnelly A, Walsh A, Hurley H. AB099. SOH22ABS157. “Details create the big picture”: use of a national audit database to identify areas for improvement in major vascular surgical patients. Mesentery Peritoneum 2022;6:AB099.

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