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580 A regional audit & feedback intervention to improve quality of care in ovarian cancer treatment. The easy-net experience
  1. Elisa Piovano1,
  2. Eva Pagano2,
  3. Marco Camanni3,
  4. Manuela Ceccarelli4,
  5. Annamaria Ferrero5,6,
  6. Luca Fuso5,
  7. Maria Elena Laudani6,
  8. Andrea Puppo7,
  9. Giovannino Ciccone2 and
  10. Paolo Zola6
  1. 1SCDU Ginecologia e Ostetricia 2U, Ospedale Sant’Anna, AOU Città della Salute e della Scienza di Torino, Torino, Italy
  2. 2Unità di Epidemiologia Clinica, AOU Città della Salute e della Scienza di Torino, and CPO Piemonte, Torino, Italy
  3. 3Ospedale Martini-ASL Città di Torino, SC Ostetricia e Ginecologia, Torino, Italy
  4. 4Healthcare Services Direction, Ospedale Sant’Anna, AOU Città della Salute e della Scienza di Torino, Torino, Italy
  5. 5SCDU Ginecologia e Ostetricia, AO Ordine Mauriziano, Torino, Italy
  6. 6Dipartimento di Scienze Chirurgiche, Università degli studi di Torino, Torino, Italy
  7. 7SC Ostetricia e Ginecologia, Ospedale S. Croce e Carle, Cuneo, Italy


Introduction/Background In 2009 a regional audit on ovarian cancer treatment was run in the Cancer Care Network of Piemonte and Valle d’Aosta in Italy. High dispersion of patients in many low-volume hospitals was documented and 37.5% of patients received sub-optimal care. We present the re-audit and feedback (A&F) intervention performed in 2017–2020 and its impact on the quality of care.

Methodology Eight key recommendations on the initial management of ovarian cancer were selected from international guidelines. Thirteen indicators were used to describe the level of adherence to these recommendations. A global indicator of adherence (GIA) was measured as the mean percentage of compliance across all the indicators. All incident cases of ovarian cancer in the resident population were included in the audit, between May 2017 and September 2020. Data were collected in a web-based database. Multiple feedbacks were provided during the audit. Overall survival was identified as outcome indicator.

Results Among 1030 women (236–23% early and 794–77% advanced stage) the pattern of care resulted sub-optimal in about 25% of patients. During the audit, overall adherence improved from 51.3% in the first study semester to 70.4% in the last one (estimated difference +17.7%; 95%CI 12.8–22.7). The largest improvement was evidenced in the diagnostic-staging phase (figure1). Overall survival at 4 years was 87.8% among early and 39.4% among advanced stages. During the follow-up (that included the COVID period), no clear trend in 2-year survival was detected, but each 10% increase in GIA was positively associated with a better 2-year overall survival (HR 0.85; 95%CI 0.80–0.91).

Conclusion A&F was effective in improving the quality of care for ovarian cancer in Piemonte, even if a clear trend effect on short-term survival was not evident. This successful experience of A&F can be replicable in other settings and different cancers.

Disclosures The authors have no disclosures to declare. Funding: This work was supported by the Italian Ministry of Health and the Regione Piemonte as part of the Easy-Net Project, grant number NET-2016–02364191.

Abstract 580 Figure 1

Adjusted estimated effect (OR) of the study period (180 days) on the adherence (%) to selected recommendations

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