RT Journal Article
SR Electronic
T1 Province Wide Clinical Governance Network for Clinical Audit for Quality Improvement in Endometrial Cancer Management
JF International Journal of Gynecologic Cancer
JO Int J Gynecol Cancer
FD BMJ Publishing Group Ltd
SP 94
OP 100
DO 10.1097/IGC.0b013e318232cab5
VO 22
IS 1
A1 Vincenzo Dario Mandato
A1 Debora Formisano
A1 Debora Pirillo
A1 Gino Ciarlini
A1 Lillo Bruno Cerami
A1 Alessandro Ventura
A1 Lorenzo Spreafico
A1 Tamara Palmieri
A1 Giovanni Battista La Sala
A1 Martino Abrate
YR 2012
UL http://ijgc.bmj.com/content/22/1/94.abstract
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.