PT  - JOURNAL ARTICLE
AU  - Vincenzo Dario Mandato
AU  - Debora Formisano
AU  - Debora Pirillo
AU  - Gino Ciarlini
AU  - Lillo Bruno Cerami
AU  - Alessandro Ventura
AU  - Lorenzo Spreafico
AU  - Tamara Palmieri
AU  - Giovanni Battista La Sala
AU  - Martino Abrate
TI  - Province Wide Clinical Governance Network for Clinical Audit for Quality Improvement in Endometrial Cancer Management
AID  - 10.1097/IGC.0b013e318232cab5
DP  - 2012 Jan 01
TA  - International Journal of Gynecologic Cancer
PG  - 94--100
VI  - 22
IP  - 1
4099  - http://ijgc.bmj.com/content/22/1/94.short
4100  - http://ijgc.bmj.com/content/22/1/94.full
SO  - Int J Gynecol Cancer2012 Jan 01; 22
AB  - Background According to the hub-and-spoke model introduced in the Provincial Healthcare System of Reggio Emilia, early endometrial cancer is treated in peripheral low-volume hospitals (spokes) by general gynecologist, whereas more complex cancers are treated by gynecological oncologists at the main hospital (hub).Objective To guarantee a uniformly high standard of care to all patients with endometrial cancer treated in hub and spoke hospitals of Reggio Emilia Province.Methods The specialists of the 5 hospitals of Reggio Emilia Province instituted an inter hospital and multidisciplinary oncology group to write common and shared guidelines based on evidence-based medicine through the use of clinical audit. They valued the process indicators before and after guidelines introduction identifying the site of improvement and verifying the standard achievement.Results Diagnostic hysteroscopy use increased significantly from preguideline period, 53%, to postguideline period, 74%. Magnetic resonance use and accuracy increased significantly from preguideline to postguideline periods: 8.1% to 35.3% and 37.3% to 74.7%, respectively. Laparoscopy use increased from 1.6% (preguideline) to 18.6 (postguideline). Early surgical complications decreased from 16% (preguideline) to 9% (postguideline). Radiotherapy use increased from 14.% (preguideline) to 32.3% (postguideline).Conclusion It is possible for a provincial oncology group to build an oncology network providing an improvement in the assistance of patients with endometrial cancer through the use of clinical audit. Clinical audit made it possible to obtain the full attendance of specialists of various disciplines involved in the treatment of endometrial cancer to optimize response time schematizing process.