title: Quality-of-care indicators for pelvic organ prolapse: development of an infrastructure for quality assessment.
abstract: OBJECTIVE
  A paucity of data exists addressing the quality of care provided to women with pelvic organ prolapse (POP). We sought to develop a means of measuring this quality through the development of quality-of-care indicators (QIs).
  
  
  METHODS
  QIs were modeled after those previously described in the Assessing the Care of Vulnerable Elders (ACOVE) project. The indicators were then presented to a panel of nine experts. Using the RAND Appropriateness Method, we analyzed each indicator's preliminary rankings. A forum was then held in which each indicator was thoroughly discussed by the panelists as a group, after which panelists individually re-rated the indicators. QIs with median scores of at least 7 were considered valid.
  
  
  RESULTS
  QIs were developed that addressed screening, diagnosis, work-up, and both nonsurgical and surgical management. Areas of controversy included whether screening should be performed to identify prolapse, whether pessary users should undergo a vaginal examination by a health professional every 6 months versus annually, and whether a colpocleisis should be offered to older women planning to undergo surgery for POP. Fourteen out of 21 potential indicators were rated as valid for pelvic organ prolapse (median score ≥7).
  
  
  CONCLUSIONS
  We developed and rated 14 potential quality indicators for the care of women with POP. Once these QIs are tested for feasibility they can be used on a larger scale to measure and compare the care provided to women with prolapse in different clinical settings.
authors: Department of Surgery, Division of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA, Jennifer.Anger@cshs.org.
authors: Jennifer T
authors: JT
authors: Anger
authors: Victoria C S
authors: VC
authors: Scott
authors: Krista
authors: K
authors: Kiyosaki
authors: Aqsa A
authors: AA
authors: Khan
authors: Claudia
authors: C
authors: Sevilla
authors: Sarah E
authors: SE
authors: Connor
authors: Carol P
authors: CP
authors: Roth
authors: Mark S
authors: MS
authors: Litwin
authors: Neil S
authors: NS
authors: Wenger
authors: Paul G
authors: PG
authors: Shekelle
mesh_terms: D003697:Delphi Technique; D019317:Evidence-Based Medicine; D005260:Female; D006126:Group Processes; D006801:Humans; D056887:Pelvic Organ Prolapse / Q000175:diagnosis* / Q000628:therapy*; D017064:Process Assessment, Health Care; D019984:Quality Indicators, Health Care
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