Clinical governance network for clinical audit to improve quality in epithelial ovarian cancer management

Journal of Ovarian Research

Giovanni Battista La Sala⁷  Debora Formisano²  Laura Maria Beatrice Belotti^1,12  Chiara Ventura^1,12  Rossana De Palma^1,12  Ruby Martinello¹  Federica Rosati⁹  Andrea Amadori⁴  Bruno Lenzi⁵  Alessandro Ventura⁸  Giuseppe Comerci⁶  Maurizio Leoni³  Gino Ciarlini^1,11  Debora Pirillo^1,11  Pierandrea De Iaco^1,10  Martino Abrate^1,11  Vincenzo Dario Mandato^1,11 

[1] Unit of Obstetrics and Gynecology, University Hospital S. Anna, Ferrara, Italy;Statistics and Clinical Epidemiology Unit, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy;Oncology and Gynecology Unit, Ospedale Civile, Ravenna, Italy;Unit of Obstetrics and Gynecology, Ospedale G.B. Morgagni-L.Pierantoni, Forlì, Italy;Unit of Medicine, Hospital of Argenta, Ferrara, Italy;Obstetrics and Gynecology Unit Ospedale Civile, Ravenna, Italy;Department of Obstetrics and Gynecology, Arcispedale S. Maria Nuova- IRCCS; University of Modena and Reggio Emilia, Reggio Emilia, Italy;Department of Obstetrics and Gynecology, Ospedale Civile, Guastalla, Reggio Emilia, Italy;Unit of Obstetrics and Gynecology, Ospedale degli Infermi, Rimini, Italy;Department of Obstetrics and Gynecology, University Hospital S. Orsola Malpighi, Bologna, Italy;Department of Obstetrics and Gynecology, Arcispedale S. Maria Nuova- IRCCS, Reggio Emilia, Italy;Clinical Area Government, Health and Social Agency of Emilia-Romagna, Emilia-Romagna, Italy

关键词: Guide line;    Quality of care;    Clinical audit;    Centralized care;    Epithelial ovarian cancer;   

Others  :  810909
DOI  :  10.1186/1757-2215-6-19

 received in 2013-02-28, accepted in 2013-03-20,  发布年份 2013

【 摘 要 】

Background

Epithelial ovarian cancer (EOC) is the most lethal gynecological cancer. Several hospitals throughout the region provide primary treatment for these patients and it is well know that treatment quality is correlated to the hospital that delivers. The aim of this study was to investigate the management and treatment of EOC in a Region of the North Italy (Emilia-Romagna, Italy).

Methods

A multidisciplinary group made up of 11 physicians and 3 biostatisticians was formed in 2009 to perform clinical audits in order to identify quality indicators and to develop Region-wide workup in accordance with the principles of evidence-based medicine (EBM). The rationale was that, by setting up an oncogynecology network so as to achieve the best clinical practice, critical points would decrease or even be eliminated. Analysis of cases was based on the review of the medical records.

Results

614 EOC patients treated between 2007 and 2008 were identified. We found only 2 high-volume hospitals (≥ 21 patients/year), 3 medium-volume hospitals (11–20 operated patients/year), and 7 low-volume hospitals (≤ 10 operated patients /year). Only 222 patients (76.3%) had a histological diagnosis, FIGO surgical staging was reported only in 206 patients (70.9%) but not all standard surgical procedures were always performed, residual disease were not reported in all patients. No standard number of neoadjuvant chemotherapy cycles was observed.

Conclusions

The differences in terms of treatments provided led the multidisciplinary group to identify reference centers, to promote centralization, to ensure uniform and adequate treatment to patients treated in regional centers and to promote a new audit involving all regional hospitals to a complete review of the all the EOC patients.

【 授权许可】

   
2013 Mandato et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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