Quality standards for the care of people with giant cell arteritis in secondary care

Abstract

Objective GCA is the commonest primary systemic vasculitis in adults, with significant health economic costs and societal burden. There is wide variation in access to secondary care GCA services, with 34% of hospitals in England not having any formal clinical pathway. Quality standards provide levers for change to improve services. Methods The multidisciplinary steering committee were asked to anonymously put forward up to five aspects of service essential for best practice. Responses were qualitatively analysed to identify common themes, subsequently condensed into domain headings, and ranked in order of importance. Quality standards and metrics for each domain were drafted, requiring a minimum 75% agreement. Results 13 themes were identified from the initial suggestions. Nine quality standards with auditable metrics were developed from the top 10 themes. Patient Access, glucocorticoid use, pathways, ultrasonography, temporal artery biopsy, PET scan access, rheumatology/ophthalmology expertise, education, multidisciplinary working have all been covered in these quality standards. Access to care is a strand that has run through each of the developed standards. An audit tool was developed as part of this exercise. Conclusion These are the first consensus auditable quality standards developed by clinicians from rheumatology and ophthalmology, nursing representatives and involvement of a patient charity. We hope that these standards will be adopted by commissioning bodies to provide levers for change from the improvement of patient care of individuals with GCA.

Empfehlungen für die interdisziplinäre Betreuung von Patienten mit Riesenzellarteriitis: «Giant Cell Arteritis Hospital Quality Standards» (GHOST)

“…Es gibt mehrere Empfehlungen zum Management von Patienten mit RZA, zum Beispiel von der European League Against Rheumatism (EULAR) [3], der European Headache Federation [4] und der British Society for Rheumatology [5]. Kürzlich wurden in England in einer interdisziplinären Gruppe aus Rheumatologen, Ophthalmologen, Pflegefachpersonen und Vertretern einer Patientenorganisation Qualitätsstandards für die Betreuung von Patienten mit RZA in einer «Giant Cell Arteritis Hospital Quality Standards» (GHOST)-Konsensus-Publikation definiert [6].…”

Preliminary Development of a Novel Tool to Document Vessel Wall Involvement in Patients With Large-Vessel Vasculitis

“…1 However, interpretation and documentation of vessel wall involvement can be challenging due to a lack of standardized radiology reporting frameworks and unfamiliarity with vascular anatomy among rheumatologists. 2,3 Currently, the workflow at our institution involves manually copying and pasting vascular imaging reports into the patient chart at each clinical encounter. The treating physician at times may have to compare individual reports, which are often verbose and inconsistent in reporting format, to make an accurate assessment of change in vessel wall involvement over time.…”