Making vascular outcomes visible: an implementation framework for an Irish national vascular registry.

BACKGROUND

Ireland lacks a coordinated national vascular registry, despite a 2023 National Model of Care recommendation to establish one for quality improvement and implant surveillance.

AIMS: To identify transferable features of established national vascular registry and audit systems and translate them into a proportionate implementation framework for Ireland.

METHODS

A structured narrative review and comparative implementation analysis. Five mature comparator systems, purposively selected for relevance to predefined implementation domains, were characterised using contemporary programme documentation and targeted peer-reviewed literature. Features were mapped to Irish policy objectives.

RESULTS

Transferable functions included explicit measurement of case ascertainment, clinically granular procedure-specific modules, recurrent provider feedback, linkage to routinely collected data, and progressive development of risk-adjusted benchmarking and research capability. We propose an Irish registry beginning with infrarenal abdominal aortic aneurysm repair, carotid intervention, lower-limb arterial revascularisation, and major amputation. The initial architecture should combine a limited universal clinical core with procedure-specific modules, reconciliation against Hospital In-Patient Enquiry activity, structured implant capture, and rapid feedback to participating centres. Procedure-specific risk adjustment, longitudinal linkage, complex aortic modules, and participation in VASCUNET should follow only after completeness and data quality are established. Prospective pilot evaluation should measure denominator validity, case ascertainment, mandatory-field completion, data-entry burden, provider acceptability, staffing requirements, and cost per completed case.

CONCLUSIONS

Ireland does not require further proof that national vascular audit is feasible; it requires a deliberately limited, testable, and sustainably commissioned implementation model.