Introduction

Welcome to the APSA Quality and Safety Committee Vascular Anomalies Toolkit. This page is intended to help anyone who is interested in Quality Improvement (QI) of the management of patients with vascular anomalies.

Available toolkit projects are listed below. Many of the approaches described are evidence-based - some are not. These approaches have not been approved by APSA.

Please add a header titled "Development of a Vascular Anomalies Clinic"

The treatment of patients with vascular anomalies can be highly specialized and challenging. As such, the development and maintenance of a multidisciplinary vascular anomalies clinic (VAC) is complex. This section intends to provide guidelines and elements that may be helpful in the development of a program to care for such patients. It is a complilation of the efforts of various institutions and organizations, such as Kaiser Permanente Roseville, Children’s Hospital of Los Angeles, and the VASCERN european collaborative.

Protocol:

Resources:

• Vascular Anomalies Classification
  • ISSVA Classification for Vascular Anomalies (2018)
• Program Development
  • Vascular Anomalies Clinic Organizational Overview
  • Kaiser Permanente Roseville - General Patient Evaluation Flow Chart
  • Sample Template for VAC Intake History (for Medical Assistants)
  • VAC Medical Assistant In Person Clinic Set Up Instructions
  • VAC Medical Assistant In Absentia Clinic Set Up Instructions
• Treatment Algorithms
  • Lymphatic Malformations
    
    • Kaiser Permanente Roseville - IR 3-day Sclerotherapy Protocol (Abdominal Lymphatic Malformation)
    • CHLA Abdominal Lymphatic Malformation Treatment Algorithm
    • CHLA Cervicofacial Lymphatic Malformation Treatment Algorithm
    • European Reference Network VASCERN Lymphatic Malformation - Treatment Overview
    • European Reference Network VASCERN Simple/Common Lymphatic Malformation - Diagnosis, Management and Treatment
    • European Reference Network VASCERN Diffuse/Extensive Lymphatic Malformation - Management and Treatment
  • Hemangiomas
    • Kaiser Permanente Roseville - Propranolol for Infantile Hemangioma Guidelines
    • MCW Propranolol Inpatient Guidelines
    • MedStar Washington Hospital - Case Report - Treatment for Fibrofatty Residua of Involuted Hemangioma
  • Venous Malformations
    • Intramuscular Venous Malformations Algorithm
  • Vascular Anomalies Standard Labs
    • Kaiser Permanente Roseville - Vascular Anomalies Standard Labs
• Epic Smartphrases
  • Clinic Note Templates
    • Sample Template for VAC Intake History (for Medical Assistants)
    • Kaiser Permanente Roseville - Vascular Anomalies Clinic, Initial Consultation Note
    • Kaiser Permanente Roseville - Birthmark and Vascular Anomaly Clinic Note
    • Kaiser Permanente Roseville VAC In-Absentia Note
    • Kaiser Permanente Roseville In-Absentia Birthmark and VAC Clinic Note
    • Kaiser Permanente Roseville - Consult Note, Assessment and Plan for a Vascular Lesion
  • Operative Note Templates
    • Kaiser Permanente Roseville Op Note - Sclerotherapy
    • Kaiser Permanente Roseville Op Note - Sclerotherapy with Ultrasound and Fluoroscopy
  • Orders
    • Kaiser Permanente Roseville Doxycycline for Intralesional Injection Order
  • Problem List Information and Entries
    • Kaiser Permanente Roseville - Infantile Hemangiomas -Timolol & Propanolol Treatment Recommendations for PCPs
    • Kaiser Permanente Roseville - Problem List VAC Recommendations Summary
      • Smartphrase used to populate a patient’s problem list, which can then be incorporated to the clinic note’s assessment and plan
    • Kaiser Permanente Roseville - Problem List VAC In-Absentia Recommendations Summary
    • Kaiser Permanente Roseville Problem List VAC Pre-Clinic Review
  • Patient Information
    • Kaiser Permanente Roseville - Patient Information - Vascular Malformations (General Information and Overview)
    • Kaiser Permanente Roseville - Patient Information - Sclerotherapy

Stakeholders: Vascular Anomalies Clinic team members

Challenges and solutions:

• Treatment of patients with vascular anomalies can be highly specialized and challenging. As such, development and maintenance of a multidisciplinary vascular anomalies clinic is complex.

Links to published data (used to develop protocol or demonstrating success of protocol):

Submitted by: Doug Miniati, MD

Additional implementers: Jason Sulkowski, MD

Recent Research

[1][2][3][4][5][6][7][8][9][10]

References

[11]

References