Abdominal aortic aneurysm, improving outcomes for patients

This project aimed to reduce mortality rates for abdominal aortic aneurysm (AAA) surgery in the UK from 7.5% to 3.5% by 2013. It focused on making surgery for AAA as safe as possible, and on supporting the introduction of the National Abdominal Aortic Aneurysm Screening Programme.

Key findings

• UK AAA mortality rate has decreased significantly since the baseline measure of 7.5% in 2008.
• Data collection was improved for the National Vascular Database (NVD) from 66% to 84% nationally.
• Working as a multi-disciplinary team is critical to a successful approach.
• A shared learning approach helps teams avoid repeating mistakes and speeds up improvements.

Challenges

• Lack of quality improvement experience was a major obstacle.
• A longer time frame was needed to deliver a national project regionally.
• The initial care pathway developed was too lengthy in practice and was adapted to make it more practical.
• Large external agendas, such as service reconfiguration, had an impact on the engagement and progress of quality improvement work.
• A standard cooperation agreement for running UK-wide initiatives would facilitate such projects.
• An absence of baseline measures made it difficult to measure outcomes of implementing best practice protocols.

Who was involved?

The project was carried out by the Audit and Research Committee of the Vascular Society of Great Britain and Ireland – the professional body representing vascular surgery. It was led by Mr David Mitchell, chair of the committee and a Consultant Vascular and Renal Transplant Surgeon at Southmead Hospital, North Bristol NHS Trust.

The project was run in partnership with the Circulation Foundation, the Vascular Anaesthetic Society of Great Britain and Ireland, and the British Society of Interventional Radiology.