Vincenzo Dario Mandato1, Federica Torricelli2, Valentina Mastrofilippo3, Debora Pirillo4, Gianluca Annunziata4, Gino Ciarlini3, Giovanni D'Ippolito4, Erminia DI Bartolomeo5, Lorenzo Aguzzoli3. 1. Unit of Obstetrics and Gynaecology, Azienda Unità Sanitaria Locale - IRCCS, Reggio Emilia, Italy; dariomandato@gmail.com. 2. Laboratory of Translational Research, Azienda Unità Sanitaria Locale - IRCCS, Reggio Emilia, Italy. 3. Unit of Surgical Gynecol Oncology, Azienda Unità Sanitaria Locale - IRCCS, Reggio Emilia, Italy. 4. Unit of Obstetrics and Gynaecology, Azienda Unità Sanitaria Locale - IRCCS, Reggio Emilia, Italy. 5. Transfusion Medicine Unit, Azienda Unità Sanitaria Locale - IRCCS, Reggio Emilia, Italy.
Abstract
BACKGROUND/AIM: Most women are managed by a general gynaecologist rather than being centralized in an oncogynaecology unit, resulting in different clinical management. In 2006, a hub & spoke model was introduced in the Provincial Healthcare System of Reggio Emilia, and shared guidelines were written. We aimed to verify the adherence to guidelines and the consequent improvements in quality care. PATIENTS AND METHODS: All patients who underwent a hysterectomy for endometrial cancer in the Reggio Emilia Province hospitals from 2000 to 2016 were included in the study. Clinical and pathological data were carefully recorded for each patient included. RESULTS: This study included 132 and 277 patients in the periods before and after the implementation of the guideline, respectively. In the post-guideline period, the use of hysteroscopy, magnetic resonance, laparoscopy and adjuvant treatment significantly increased. CONCLUSION: Common shared guidelines and a clinical audit can help in improving centralization, resulting in an increased quality of care.
BACKGROUND/AIM: Most women are managed by a general gynaecologist rather than being centralized in an oncogynaecology unit, resulting in different clinical management. In 2006, a hub & spoke model was introduced in the Provincial Healthcare System of Reggio Emilia, and shared guidelines were written. We aimed to verify the adherence to guidelines and the consequent improvements in quality care. PATIENTS AND METHODS: All patients who underwent a hysterectomy for endometrial cancer in the Reggio Emilia Province hospitals from 2000 to 2016 were included in the study. Clinical and pathological data were carefully recorded for each patient included. RESULTS: This study included 132 and 277 patients in the periods before and after the implementation of the guideline, respectively. In the post-guideline period, the use of hysteroscopy, magnetic resonance, laparoscopy and adjuvant treatment significantly increased. CONCLUSION: Common shared guidelines and a clinical audit can help in improving centralization, resulting in an increased quality of care.