Audit on compliance with 2017 ESVS pre op carotid imaging guidance, by Emily Alderson.

Emily Alderson

ESVS 2017 guidance clarified: stated as either 2 forms of imaging, or duplex repeated by different operators.

Objectives:

1) check compliance: did a pilot check and found 71.4% Jan to Jun 2019 6 month check

2) Explore reasons for non compliance

3) re-audit

Method

Got data from NVR

Found Jan 2019 to Dec 2021 = 205 CEAs in 3 years

EPIC used to identify all needed info: demographics, referrals, etc.

SPSS for analysis

Overall 87.3% compliant with guideline.

No difference between hub and spoke referrals

Checked between referral pathways arising from the stroke team or not = no differences in compliance

Checked whether only 1 scan were for mainly those who had their CEA done within 14 days: No difference

Did Covid have an impact, looked March 2020 - 2021; turned out to be in CV19 there were 94% that had compliance.

Checked this above figure again to ensure was not just a case of better compliance with progressing years; not, therefore - >

Relationship was unique to Covid and not to progression over years.

Future considerations:

Pathway mapping.

MDTM input missing? There is one bitsaying MDT theatre list review.

Multifaceted pathway.

I offered comments: Excellent work. Particularly I meant the focus on ferreting out the cover data. Also meant the attention to detail in checking if not due to 14 day target etc. Later on in discussion in response to another qn also clarified that not based on one or two consultant outliers.

I asked if worth knowing specifically about discrepancies between CTA / MRA vs. duplex rather than just the compliance within guidelines (gave clinical examples). EK has this data and is intending to look through.