Vascular services at Hospital Pulau Pinang

Abstract

The availability of vascular surgery services is relatively recent in Malaysia. An audit was undertaken to determine the magnitude and trend of the workload in a Tertiary Referral Centre with 1,236 beds. A retrospective review of outpatient attendances, non-invasive vascular investigation, and operative workload was carried out. A prospective running audit waiting list for haemodialysis vascular access construction and maintenance was also conducted. All items of service were found to be on the increase. The mean number of patients seen as new referrals and follow-up patients increased 35.9% (13.1 to 17.8) and 123.3% (26.6 to 59.4) respectively. The prospective running audit of the waiting list for haemodialysis vascular access construction increased from by 51.1 % (47-71) despite a mean of 5 .5 procedures being performed a week. The current vascular surgery services involve limb and life-preserving procedures such as haemodialysis vascular access construction and maintenance, long-term intravenous access, major arterial reconstruction and intervention for trauma. Service workload is substantial and staffing inadequate. An increase in staffing and an independent operational budget is required to cope with service requirements.