Improving the quality of care for people with giant cell arteritis

Mukhtyar, Chetan, Ducker, Georgina, Fordham, Sarah, Mansfield-Smith, Sonja and Jones, Colin (2021) Improving the quality of care for people with giant cell arteritis. Clinical Medicine, Journal of the Royal College of Physicians of London, 21 (4). E371-E374. ISSN 1470-2118

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Abstract

Giant cell arteritis (GCA) is a systemic vasculitis with numerous potential complications and societal costs. After the publication of international guidelines, we found a number of deficiencies in the local care pathway of patients suspected to have GCA. These included poor referral and management pathways, and absence of dedicated monitoring and follow-up. In this paper, we describe a 10-year transformation which led to our service being nominated for a national award. A comprehensive consensus pathway saw referral numbers rise from 19 to 135 from 2012 to 2019. A consensus management pathway has meant that patients are assessed within 2 days of referral and glucocorticoids started at point of referral. All patients with suspected GCA are clerked and managed according to this agreed pathway which is available on the hospital intranet. The introduction of diagnostic ultrasonography has meant that the need for biopsies has dropped by >80% reducing the annual cost of diagnostics by >£140, 000. The introduction of a vasculitis specialist nurse has resulted in improving education, contact and speed of access to our service. The improvements in the service resulted in our service becoming a finalist in the Royal College of Physicians Excellence in Patient Care Award in 2020.

Item Type: Article
Additional Information: Funding Information: The authors would like to thank Chetan Mukhtyar’s trainees Chloe Lapraik, Louise Hamilton, Anita Weerakoon, Khadi Afridi, Max Yates, Eleana Ntatsaki, Mark Sykes, Poonam Sharma, Rasha Briar, Rita Abdulkader, Alice Malpas, Cee Yong, Anoushka Seneviratne, Lauren Steel, Sadaf Saeed, Dimos Merinopoulos, Abid Yousuf and Rifat Mazumder in Rheumatology during this time; Colin Jones’s trainees Matt Schneiders and Sofia Habib in Ophthalmology; Chandrashekhara Rai and Anne Howden for supporting the service; Norfolk and Norwich Hospitals Charity for funding the ultrasound machine; Professor Max Bachmann for his advice on costing the service; and Ms Sarah Walker for her role as operational manager for the business cases. Publisher Copyright: © Royal College of Physicians 2021. All rights reserved.
Uncontrolled Keywords: diagnostic ultrasonography,giant cell arteritis,multidisciplinary collaboration,temporal artery biopsy,vasculitis specialist nurse,medicine(all) ,/dk/atira/pure/subjectarea/asjc/2700
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Depositing User: LivePure Connector
Date Deposited: 22 Dec 2021 14:30
Last Modified: 24 May 2022 14:45
URI: https://ueaeprints.uea.ac.uk/id/eprint/82796
DOI: 10.7861/CLINMED.2021-0126

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