UK recommendations for AAA screening organisation {2} were used to describe quality assurance (QA) aspects of systematic population-based AAA screening.

QA systems support commissioners and providers in clinical governance so that core processes are safe and the programme achieves better outcomes. Several activities are involved, including:

• accredited training programmes and continuing professional development of staff
• regular appraisal and refresher training
• standardised calibration of equipment
• monitoring of standardised outcome and performance information with feedback of comparative information to local services from national analysis of screening data, AAA surgery and AAA deaths
• site visits for peer review
• supporting activities for avoidance and management of serious incidents

Ultrasound equipment

• range of standard commercial phantom test objects used, with tests undertaken by an independent Registered Clinical Scientist (Medical Physics)
• periodic testing
• as per acceptance tests, using the same test objects and undertaken by the similarly qualified staff and results reported to the screening office Carried out on an annual basis
• regular testing
• QA checks done at routine maintenance service by equipment manufacturer, carried out at service intervals detailed by the manufacturer
• routine monthly tests using a standard test object carried out locally by the senior sonographer and results reported to the screening office

Other

• questionnaires sent periodically to a sample of randomly selected service users (doctors, practice managers/staff, patients, vascular surgeons) to ask whether any problems arose as a result or in connection with the screening programme
• enquire about any procedural changes that could improve the delivery of the screening programme
• monitor time from referral to outpatient consultation
• referral to vascular unit
• monitor time from referral to surgery {2}