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Our Quality Measures

We are absolutely determined to provide the highest possible quality of care to all our patients.

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Our Quality Standards

We are very grateful to Ken Lownds of Zero Harm Healthcare Ltd who has helped us develop our comprehensive Safety Management and Quality Management Systems. Ken has worked for many years in the airline industry and is now committed to helping healthcare organisations learn from the enviable safety record of the airlines.

We have also looked at examples in measuring quality and safety in the health sector worldwide and have been impressed with the work done at Cincinnati Children’s hospital. Over the last 11 years they have been recording all safety events and plotting them on easy to interpret graphs. They are happy to share their results which are displayed on their website together with explanations of why the measures are important, how they measure, and what they are doing to improve. This enables targets to be set and measurement against such targets to constantly improve safety, quality and outcomes.

We have rather unashamedly copied the work done at this famous hospital and you will see below links to various important quality and safety measures over the last 5 years at Veincentre. We have also included progress over 5 years on some other measures like value for money. Like Cincinnati Children’s hospital, we are leaders in our field and also happy to share our results with any visitor to this site.

Our commitment to quality improvement is embedded throughout our business, and the benefits are felt every day by our patients.

So, how do we measure up?

Please click on each of the following measures to reveal our performance over the last 5 years. We have set target levels based on the published literature to ensure that we are meeting and preferably exceeding the standards set by international comparable services.

Why is this measure important?

Never Events are serious, largely preventable patient safety incidents that should not occur if existing national guidance or safety recommendations have been implemented by healthcare providers. Each never event type has the potential to cause serious patient harm or death. However, serious harm or death is not required to have happened as a result of a specific incident occurrence for that incident to be categorised as a never event.

As the name suggests these events should never happen. If just one never event occurs it may well indicate serious failings in the safety management system of the organisation and would require robust investigation and action to avoid repeats.

As far as our patients are concerned such events would include: Wrong site surgery e.g. operating on the left leg when it should have been the right; Retention of a foreign body that is not immediately removed.

 

How do we measure it?

We record all adverse events and examine these records to detect if any would be classified as a never event.

 

What are we doing to improve it?

There is no need at present to improve this record but if a never event were to happen we would undertake a robust investigation and inform the CQC.

Why is this measure important?

Adverse incidents are any event that should not have happened which poses a risk or has caused actual harm to a patient. It is vital that we record all such incidents in order to learn lessons from them to prevent future such events.

Ideally, we would want to see a reduction in the rate of adverse incidents over time.

 

How do we measure it?

We have a strict adverse incident reporting system which should catch all such incidents in any of our clinics. There is a central record of these and the figures on the graph are from those records.

 

What are we doing to improve?

As can be seen from the trend there was a small increase in adverse incidents reported between 2013 – 2019. This is disappointing but may well reflect better reporting rather than a true increase. The actual numbers remain small and the severity of the vast majority of the incidents has been low. There was a slight drop over the last year which is good to see although we would naturally expect a bit of up and down variation from one year to the next. Comparison with threshold rates published in the Multi Society consensus quality improvement guidelines show our rates remain far lower than average.

We investigate all such incidents and undertake a root cause analysis on serious events in order to learn lessons and try to avoid repeats. The results of the investigations are shared with all staff in all our clinics.

 

Why is this measure important?

DVT is a serious yet common complication of surgery of any sort. DVT can lead to long term disabling symptoms in the leg from chronic venous insufficiency.

 

How do we measure it?

All DVT’s are recorded as adverse incidents and identified separately. We record the numbers of these identified each year either by us or reported back to us by the patients. This number is then adjusted as a figure per 1,000 patients treated in order to accurately compare one year to another.

 

What are we doing to improve it?

It will never be possible to reduce DVT to zero, but we undertake risk assessments for this on every patient and give prophylactic blood thinners to any at risk. We have protocols designed to minimise this risk and we audit regularly to ensure these protocols are being abided by. We saw a slight increase in 2018 and again in 2019 which is disappointing but this is still below our aim level of 1 in 1000 treatments and way below the rate published in the literature. We investigated all to determine if we should have done anything differently but there were no risk factors in any of the patients and nothing unusual about the cases so no action was necessary or possible.

Why is this measure important?

SSIs are one of the commonest complications following surgery. They can be serious potentially leading to sepsis and threatening life. Even when less serious they are painful and can take a long time to resolve and can lead to cosmetically unattractive scars. Although the risk of SSI is very low with minimally invasive procedures as the incisions are either absent or very small it is important that we record numbers and hopefully see a reduction over time. A high rate of SSI would indicate a probable breakdown in our infection control procedures.

 

How do we measure it?

All SSIs are recorded as adverse incidents and we examine these reports regularly to determine how many SSIs have occurred.

What are we doing to improve it?

Whenever we have a SSI we undertake an investigation to determine if there is anything that we did that increased the risk of the infection occurring and if there are any actions we can take to minimise the chance of further incidents. Our rate is far below the threshold as set out in the Multi Society Consensus Quality Improvement guidelines so there is little that we can or need to do to improve beyond current rates. We are very pleased that none of our patients experienced a SSI in 2018 and 2019.

Why is this measure important?

Skin burns are a recognised complication of EVLA. They can be nasty as the burn is from inside out so a full thickness burn. These can become infected. They also leave a permanent scar after healing.

 

How do we measure it?

All skin burns would be recorded as an adverse incident and from these reports, we discover how many occur each year.

 

What are we doing to improve it?

As we have seen no skin burns over the last 8 years there is no action we need to take further than our standard operating procedures which appear to be working to avoid this complication. We have in fact never seen a case of a skin burn following EVLA but did see two cases of skin burns after RF ablation in the first three years of our service back in 2003-5. We no longer use RF ablation partly for this reason.

Why is this measure important?

Analysis of complaints forms a vital part of our clinical governance and our quality improvement strategy. Although we can learn much from complaints we would prefer the number to below as this reflects satisfaction with the service we are providing.

 

How do we measure it?

All complaints are recorded and from these records, we can see how many we receive each year and compare them with the numbers of patients we see.

What are we doing to improve it?

Over the last six years, there has been a drop in the rate of complaints received per 1000 patients seen but we are not complacent. Most complaints relate to a misunderstanding about the possibility of side effects of treatment and costs. We work very hard to keep patients fully informed about likely results, timescales, costs and possible complications. We also investigate all complaints, learn lessons from them, communicate these to all staff and take action to try to avoid repetitions.  We hope that by doing this we will continue to reduce complaints to a minimum.

 

Why is this measure important?

The cost of treatment is important to most patients. Even billionaires don’t want to waste their hard-earned money! More importantly, it is well recognised in healthcare that providing a high-quality service is actually more cost-effective.

 

How do we measure it?

The price charged for the most common procedure adjusted for annual rate of inflation. This is expressed as what the price would have been in previous years if we had increased our prices year on year by the inflation rate for that year. The latest year’s figures are the actual price for that year.

We have not increased our prices since 2005 over which time general inflation has been 48%. Medical inflation has been even higher. If we had increased our prices in line with inflation since 2005 our current price for EVLA of both legs would be £2949.

What are we doing to improve it?

As you can see from the graph our prices continue to reduce in real terms after allowing for inflation and we are consistently shown to offer the best value in the UK. We are determined to keep our costs down by running an efficient business and eliminating as much waste as possible while maintaining quality and outcomes. We constantly look at the price we pay for all goods and services we buy to obtain the highest possible value. We buy on strict specification rather than brand and negotiate deals by buying in bulk direct from the Original Equipment Manufacturers OEMs. We always try to fill lists to make the best use of staff and fixed resources.

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