CIRSE Clinical Practice Survey: Patient safety and quality improvement in IR

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Andreas Mahnken

Andreas Mahnken (University Hospital Marburg, Marburg, Germany), distinguished interventional oncologist, educator and advocator for interventional radiology (IR) standardisation, dives into the most salient outcomes from the recent Cardiovascular and Interventional Radiological Society of Europe (CIRSE) Clinical Practice Survey.

Interventional radiology—IR—has become a clinical discipline, with interventional radiologists ideally taking care of the entire patient pathway, from initial multidisciplinary tumour board (MDT) assessment to discharge and follow-up.1 The implementation of continuous quality improvement (QI) activities represents a major factor for high-quality provision of clinical care as well as patient safety.1-3 To what extent such activities as well as the use of patient safety checklists are currently undertaken by interventional radiologists was part of the recent CIRSE Clinical Practice Survey, conducted by the CIRSE Clinical Services in IR Task Force from November 2023 to January 2024.4-5 The findings of the survey will further feed into CIRSE’s activities supporting clinical practice building, quality management and patient safety in IR.

The CIRSE Clinical Practice Survey included 63 structured items addressing the areas of clinical practice training, infrastructure and personal experience as well as patient safety and continuous quality improvement. Eight items were dedicated to the latter two topics. The survey collected a total of 520 responses and was closed in January 2024.

The member survey, which was answered by interventional radiologists from Europe and beyond, showed encouraging results with over half of the respondents having an established clinical practice as well as direct patient access, taking primary responsibility for patient care. A total of 77.3% of respondents indicated the regular use of patient safety checklists (Figure 1), which is strongly encouraged by CIRSE, with a checklist dedicated to IR being available in multiple languages.

In terms of continuous quality improvement, 68.1% indicated that they perform dedicated quality improvement activities. These included recording morbidity and mortality data (70.9%), daily case discussion (68.1%) and MDT outcome (56.5%). In the open responses, respondents to this question indicated most frequently case discussions, education and certification, quality assurance registries or programmes, audits, checklists and team teachings as regular activities in their departments.

While the vast majority of responding interventional radiologists actively engage in continuous QI activities and the use of patient safety checklists, there is still room for improvement and the European IR community will take advantage of the survey results to further design tools that will help interventional radiologists engage in clinical practice activities and encourage dedicated IR quality improvement. As part of this process a clinical practice manual was developed and CIRSE actively supports quality-driven accreditation measures, such as the International Accreditation System for Interventional Oncology Services (IASIOS).1

The full results of the survey have been published in the journal CardioVascular and Interventional Radiology (CVIR) with Anthony Ryan (University Hospital Waterford, Waterford, Ireland) as lead author.4 A presentation on the results relating to quality improvement and patient safety was held at the CIRSE 2024 annual congress (14–18 September, Lisbon, Portugal) and is available in the CIRSE Library.5

References:

  1. Mahnken, A.H., Boullosa Seoane, E., et al. CIRSE Clinical Practice Manual. Cardiovasc Intervent Radiol 44, 1323–1353 (2021). https://doi.org/10.1007/ s00270-021-02904-3.
  2. Binkert, C.A. Fostering clinical practice in IR regardless of (sub) specialty status. CVIR Endovasc 6, 23 (2023). https://doi.org/10.1186/s42155-023- 00370-1.
  3. Morgan, R., Haslam, P., et al. Provision of Interventional Radiology Services 2023. Cardiovasc Intervent Radiol 47, 3–25 (2024). https://doi. org/10.1007/s00270-023-03600-0.
  4. Ryan, A.G., Slijepcevic, B., et al. Developing a Clinical Service in Interventional Radiology: Results from the 2024 CIRSE Clinical Practice Survey. Cardiovasc Intervent Radiol (2024), https://doi.org/10.1007/ s00270-024-03858-y.
  5. CIRSE 2024 Book of Abstracts. Cardiovasc Intervent Radiol 47 (Suppl 7), 441–1880 (2024). https://doi. org/10.1007/s00270-024-03850-6.

Andreas Mahnken is an interventional radiologist and oncologist at the University of Marburg, Marburg, Germany.


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