Authors: Iñaki Imaz, Sonia García-Pérez, Jesús González-Enríquez, Javiera Valdés, Andrés Fernández-Ramos, Carmen Bouza, Antonio Sarría-Santamera
Internal reviewers: Paolo Giorgi Rossi, Mirjana Huic, Aurora Llanos, Ingvil Sæterdal
Hospital volume, surgeon volume, and surgeon´s specialisation in vascular surgery have all been found to be highly associated with mortality when an AAA is detected and repaired, which makes it advisable that both, open and endovascular repair of intact AAAs should be performed by high volume hospitals and high volume surgeons. More information about the volume—outcome relationship is in result card RC-SAF4.
Recommendations for quality assurance that are provided in the “Organisational Aspects” domain are applicable to this question (RC-ORG3 and RC-ORG15). A summary of the recommendations applicable to the safety of an AAA screening programme are the following.
Quality of screening should be guaranteed by applying several criteria – appropriate training of staff, standardised calibration of equipment, monitoring screening outcome and performance (AAA related morbidity and mortality). All monitoring processes should be carried out using information technology (identification and collation of screening cohort; management of administration, screening and referral process; recording of AAA surgery and outcomes).
Human resources for AAA screening should include: clinical staff (director/clinical lead, ultrasound clinician, consultants in vascular units), screening staff (ultrasound screening technicians, clinical skills trainer, nurse practitioner), management/administration/technical staff (coordinator, clerical officer, medical physicist, IT lead), governance (strategic health authorities, primary care trusts, primary care providers, local screening programme, diagnostic and treatment services).