609 Referral for Temporal Artery Biopsy: A Closed-Loop Audit to Improve Quality of Referrals with A Standardised Proforma

Aim Temporal artery biopsies are performed by the ENT department within our hospital, with referrals generally coming from the Rheumatology team. The motivation to audit practice came from concerns that patients were perhaps not fully aware when a referral had been made, that they may not have understood the logistical implications of this and that key pieces of information were frequently missing. We aimed to audit current practice to assess overall quality of referrals in line with GMC guidance. Method We retrospectively audited all referrals for a temporal artery biopsy procedure between July 2018 – March 2020. Assessed the quality of referrals by presence of information relating 15 data points taken from GMC guidelines, covering patient demographics, investigation results and operative factors. In collaboration with the Rheumatology team, we designed and introduced a standardised referral proforma. We re-audited the quality of referrals between June – November 2020. Results In the baseline audit of 34 referrals, 2 of the 15 data points were present in 100% of referrals, 5 were present in 50-90%, and 8 were present in < 50%. Two patients were found to be unaware a referral had been made for a biopsy. Upon re-audit after introduction of the standardised proforma; out of 9 referrals, 14 out of the 15 data points were included in 100% of referrals. Conclusions Following introduction of a standardised referral proforma we saw significant improvements in the overall quality of referrals for temporal artery biopsy. We plan to continue to prospectively audit the pathway to ensure these improvements are sustained.