Recent NVR Annual Reports describe various improvements in the quality of care delivered to patients with vascular disease, including significant increases in patients’ survival after elective surgery over the last 10 years (92.8% in 2008, which had increased to 97.4% in 2021). A key goal for the NVR is to ensure arterial procedures continue to be delivered safely.
The primary NVR improvement goals for the coming contract period (2023-2025) are to address the areas of concern highlighted in the most recent Annual Report:
- Variation in the proportion of open to endovascular procedures (EVAR) performed, particularly for elective and emergency AAA repair.
- Long waiting times through care pathways after referral/assessment to elective AAA repair.
- Variation in the time taken for patients to move through the pathways between initial symptom and carotid endarterectomy (CEA).
- Variation in the time taken for patients undergoing a lower limb revascularisation procedure following a non-elective admission for chronic limb threatening ischaemia.
- Variation between providers for patients who have a major lower limb amputation receiving care as recommended in the VSGBI Amputation Quality Improvement Framework (QIF).
Introduction to QI
We have provided links to a number of useful sites that give a good introduction to Quality Improvement
| Source | Title |
|---|---|
| Royal College of Surgeons of England | RCS and Quality Improvement |
| Royal College of Surgeons of England | Quality improvement in surgery |
| HQIP | e-Learning introduction to quality improvement for healthcare professionals |
| Hughes, RG | Tools and strategies for quality improvement and patient safety |
| Health Foundation | Quality improvement made simple |
| Health Foundation | Improvement collaboratives in healthcare |
| NICE | Putting NICE Guidance into practice |
| NHS Wales | 1000 Lives Improvement |
Tools for QI
A number of organisations provide tools for QI
| Source | Title |
|---|---|
| NHS Improvement | Quality, service improvement and redesign (QSIR) tools by stage of the patient pathway |
| NHS Improvement | Quality, service improvement and redesign (QSIR) tools by type of task |
| Institute for Healthcare Improvement | Quality Improvement Essentials Toolkit |
| HQIP | A guide to quality improvement methods |
| East London NHS Foundation Trust | Quality Improvement Resources |
Process Mapping
| Source | Title |
|---|---|
| BMJ – Trebble et al | Process mapping the patient journey: an introduction |
| NHS Improvement | Conventional Process Mapping |
| NHS Institute for Innovation and Improvement | Process mapping, analysis and redesign |
Driver Diagrams
| Source | Title |
|---|---|
| NHS Improvement | Driver Diagrams |
| East London NHS Foundation Trust | Driver Diagrams |
Models for Improvement
| Source | Title |
|---|---|
| NHS Improvement | PDSA cycles and the model for improvement |
| East London NHS Foundation Trust | The model for improvement |
| Institute for Healthcare Improvement | An introduction to the model for Improvement (video) |
| Institute for Healthcare Improvement | Testing Changes |
QI Case Studies
Below is a list of QI case studies. Please contact us if you have any good examples of QI studies for vascular surgery and we can add to this list.