The impact of a quality assurance process on the frequency and confirmation rate of hysterectomy

Gambone JC, J C Gambone, Joseph C. Gambone, Reiter RC, Robert C. Reiter, R C Reiter, J B Lench, Lench JB, Joel B. Lench, Moore JG, J G Moore
American Journal of Obstetrics and Gynecology · 1990 · vol. 163(2) , pp. 545–550 · doi:10.1016/0002-9378(90)91195-i · PMID:2386142 · W1970722470
article OA: closed CC0 ⤵ 17 in-corpus citations
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This study investigated the effect of a quality assurance process on the frequency and confirmation rate of hysterectomies performed.

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Abstract

A criteria-based quality assurance process for hysterectomy was instituted at a large teaching hospital. After this process was initiated, the overall frequency of hysterectomy decreased by 24%, p less than 0.001. Significant reductions were seen in hysterectomy rates for the following indications: chronic pelvic pain (77%, p less than 0.0001), recurrent uterine bleeding (46%, p less than 0.001), preinvasive disease of the uterus (55%, p less than 0.005), and severe infection (70%, p less than 0.025). Adenomyosis was the single indication for which an increase in hysterectomy rate was observed. This increase, however, was completely reversed during the last 2 years of the study. This quality assurance process also resulted in a significant increase in the histologic verification rate (i.e., 82% vs 93%, p less than 0.001). These observations suggest that using such a criteria-based process can reduce the number of hysterectomies performed and improve the accuracy of the preoperative diagnosis.

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MeSH descriptors

Hysterectomy Quality Assurance, Health Care California Female Hospitals, Teaching Humans Hysterectomy

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