P041 Improving suspected giant cell arteritis management in a medical ambulatory unit: a national standards service improvement project

Abstract Background/Aims GCA is a medical emergency and requires prompt recognition and management to prevent complications such as vision loss. British Society for Rheumatology guidelines (2020), GIRFT recommendations (2021) and NICE quality standards (2024) recommend key measures such as same-day initiation of steroids, urgent rheumatology review, baseline blood investigations and confirmatory diagnostic testing to improve patient care. The aim of our project was to assess the current management of patients with suspected GCA in the Same Day Emergency Care (SDEC) Unit at Basildon University Hospital, UK against these quality standards and to explore areas of service improvement. Methods A retrospective review of all suspected GCA referrals to SDEC at our centre between January 2022-March 2025 was undertaken. Data was retrieved from electronic patient records and analysed. Results A total of 140 patients with suspected GCA referred to SDEC (mean age 69.9 years, range 43-94; 70.7% female) were analysed. Referrals originated from GP (60%), ED (31.4%), acute take (5%), and neurology (3.6%), with 5(3.6%) patients referred on weekends. As summarised in Table 1, rheumatology evaluation on same working day was achieved in 83.6% (117/140), with 98.6% (138/140) patients seen within 3 working days. Same calendar day initiation of high-dose glucocorticoids attained in 75% (105/140). Documentation of GCA probability score was accomplished in 2 patients. Baseline bloods were universally checked at SDEC. Same-day ophthalmology review was achieved in 29.2% (7/25) patients. Confirmatory testing with vascular ultrasound (done by trained vascular sonographers) was performed in 91.4% (128/140) patients with confirmed GCA diagnosis in 29.3% (41/140). Nine patients underwent temporal artery biopsy following ambiguous vascular ultrasound. Conclusion Collaborative working between SDEC and rheumatology has facilitated rapid assessment and management of patients with suspected GCA at our centre, despite no formal fast-track GCA pathway in place. The key strengths of our practice are timely rheumatology review, baseline blood testing and provision of vascular ultrasound. We are addressing the areas of improvement such as structured clinical documentation and routine use of GCA probability scores by arranging refresher educational sessions, clinical posters, and integration of GCA scoring tools in SDEC workflow. Strong cross-speciality communication remains paramount to enhance safe and compliant care. Disclosure K.K. Garg: None. T. Farooq: None. S. Nafea: None. M. Khan: None. A. Rashid: None. A. Nandagudi: None. F. Ali: None.