Background

Cerebral digital subtraction angiography (DSA) follow up of various intracranial vascular abnormality is commonly performed in an elective setting under local anaesthetic. It produces shorter procedural time, avoids hospital stay and allows early identification of procedural related complication. However, the experience can still be distressing to patients due to environmental and procedural factors.

Objective

To evaluate the satisfaction with care of patients following elective admission for diagnostic cerebral DSA.

Methods

Patients electively admitted at a tertiary hospital in England between 2nd July 2021 to 6th June 2022 were invited to take part in a telephone survey. Satisfaction with various aspects of their care was rated on a five-point scale. Low performing areas were elaborated upon with free text remarks.

Results

A total of 40 patients were invited, with 20 patients partaking in the survey. 95% patients were satisfied with overall experience. 5 key themes were identified: 1) Communication- 95% patients were satisfied. 1 patient described bruising and pain after the procedure but was unsure how to deal with this. 2) Punctuality- 20% of patients described neutral experience due to rescheduling (one patient having warfarin on the day of the procedure and the rest due to unexpected intervention emergencies). 3) Environment- 100% patients were satisfied with the environment within the day case unit. 3 patients were neutral or low about the duration of the procedure due to delays in equipment preparation causing discomfort while on table. 4) Expectations- 2 patients described neutral to low satisfaction regarding accurate expectations of the procedure (prolong duration of the procedure and performing the procedure under local anaesthesia). 5) Discharge preparation- Prompt satisfactory discharge was experienced by 95% of the group. 1 patient described short delay in discharge due to puncture site pain, however, is satisfied with her concerns being addressed. 1 patient was distressed by residual dried blood at the groin access site.

Conclusions

Consistent engagement in quality improvement can improve patients experience and subsequently compliance in investigation and treatment. Good overall satisfaction was seen in patients in this study despite limitation of low recruitment number. 5 key themes were established with recommendations including focused communication and modify pathways to address patient expectations and unexpected punctuality, environmental and discharge issues.