The impact of a quality assurance process on the frequency and confirmation rate of hysterectomy.
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.
Gambone
J C
JC
Department of Obstetrics and Gynecology, UCLA School of Medicine 90024-1740.
Reiter
R C
RC
Lench
J B
JB
Moore
J G
JG
D002140:California; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data*; D011785:Quality Assurance, Health Care