Abstract
BACKGROUNDEvidence-based guidelines have been issued for ectopic pregnancy (EP), covering both diagnostic and therapeutic management. In general, guidelines aim to reduce practice variation and to improve quality of care. To assess the guideline adherence in the management of EP, we developed guideline-based quality indicators and measured patient care in various hospitals.METHODSA panel of experts and clinicians developed quality indicators based on recommendations from the Dutch guideline on EP management, using the systematic RAND-modified Delphi method. With these indicators, patient care was assessed in six Dutch hospitals between January 2003 and December 2005. For each quality indicator, a ratio for guideline adherence was calculated. Overall adherence was reported, as well as adherence per hospital type, i.e. academic, teaching and non-teaching hospitals.RESULTSOut of 30 guideline-based recommendations, 12 quality indicators were selected covering procedural, structural and outcome aspects of care. For 317 women surgically treated for EP, these aspects were assessed. Overall adherence to the guideline was 75. The highest adherence (98) was observed for performing transvaginal sonography during the diagnostic workup. The lowest adherence (21) was observed for performing salpingotomy in case of contra-lateral tubal pathology. Wide variance in adherence (0100) existed between academic, teaching and non-teaching hospitals.CONCLUSIONSThe overall guideline adherence was reasonable, with ample room for improvement in various aspects of care. Further research should focus on the barriers for guideline dissemination and adherence, to further improve the management of EP.
| Language | English |
|---|---|
| Pages | 307-315 |
| Number of pages | 9 |
| Journal | Human Reproduction |
| Volume | 26 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 1 Jan 2011 |
Keywords
- ectopic pregnancy
- guideline adherence
- health care
- practice guidelines
- quality indicators
ASJC Scopus subject areas
- Reproductive Medicine
- Obstetrics and Gynaecology
Cite this
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Guideline adherence in ectopic pregnancy management. / Mol, F.; Van Den Boogaard, E.; Van Mello, N. M.; Van Der Veen, F.; Mol, B. W.; Ankum, W. M.; Van Zonneveld, P.; Dijkman, A. B.; Verhoeve, H. R.; Mozes, A.; Goddijn, M.; Hajenius, P. J.
In: Human Reproduction, Vol. 26, No. 2, 01.01.2011, p. 307-315.Research output: Contribution to journal › Article
TY - JOUR
T1 - Guideline adherence in ectopic pregnancy management
AU - Mol, F.
AU - Van Den Boogaard, E.
AU - Van Mello, N. M.
AU - Van Der Veen, F.
AU - Mol, B. W.
AU - Ankum, W. M.
AU - Van Zonneveld, P.
AU - Dijkman, A. B.
AU - Verhoeve, H. R.
AU - Mozes, A.
AU - Goddijn, M.
AU - Hajenius, P. J.
PY - 2011/1/1
Y1 - 2011/1/1
N2 - BACKGROUNDEvidence-based guidelines have been issued for ectopic pregnancy (EP), covering both diagnostic and therapeutic management. In general, guidelines aim to reduce practice variation and to improve quality of care. To assess the guideline adherence in the management of EP, we developed guideline-based quality indicators and measured patient care in various hospitals.METHODSA panel of experts and clinicians developed quality indicators based on recommendations from the Dutch guideline on EP management, using the systematic RAND-modified Delphi method. With these indicators, patient care was assessed in six Dutch hospitals between January 2003 and December 2005. For each quality indicator, a ratio for guideline adherence was calculated. Overall adherence was reported, as well as adherence per hospital type, i.e. academic, teaching and non-teaching hospitals.RESULTSOut of 30 guideline-based recommendations, 12 quality indicators were selected covering procedural, structural and outcome aspects of care. For 317 women surgically treated for EP, these aspects were assessed. Overall adherence to the guideline was 75. The highest adherence (98) was observed for performing transvaginal sonography during the diagnostic workup. The lowest adherence (21) was observed for performing salpingotomy in case of contra-lateral tubal pathology. Wide variance in adherence (0100) existed between academic, teaching and non-teaching hospitals.CONCLUSIONSThe overall guideline adherence was reasonable, with ample room for improvement in various aspects of care. Further research should focus on the barriers for guideline dissemination and adherence, to further improve the management of EP.
AB - BACKGROUNDEvidence-based guidelines have been issued for ectopic pregnancy (EP), covering both diagnostic and therapeutic management. In general, guidelines aim to reduce practice variation and to improve quality of care. To assess the guideline adherence in the management of EP, we developed guideline-based quality indicators and measured patient care in various hospitals.METHODSA panel of experts and clinicians developed quality indicators based on recommendations from the Dutch guideline on EP management, using the systematic RAND-modified Delphi method. With these indicators, patient care was assessed in six Dutch hospitals between January 2003 and December 2005. For each quality indicator, a ratio for guideline adherence was calculated. Overall adherence was reported, as well as adherence per hospital type, i.e. academic, teaching and non-teaching hospitals.RESULTSOut of 30 guideline-based recommendations, 12 quality indicators were selected covering procedural, structural and outcome aspects of care. For 317 women surgically treated for EP, these aspects were assessed. Overall adherence to the guideline was 75. The highest adherence (98) was observed for performing transvaginal sonography during the diagnostic workup. The lowest adherence (21) was observed for performing salpingotomy in case of contra-lateral tubal pathology. Wide variance in adherence (0100) existed between academic, teaching and non-teaching hospitals.CONCLUSIONSThe overall guideline adherence was reasonable, with ample room for improvement in various aspects of care. Further research should focus on the barriers for guideline dissemination and adherence, to further improve the management of EP.
KW - ectopic pregnancy
KW - guideline adherence
KW - health care
KW - practice guidelines
KW - quality indicators
UR - http://www.scopus.com/inward/record.url?scp=79251526505&partnerID=8YFLogxK
U2 - 10.1093/humrep/deq329
DO - 10.1093/humrep/deq329
M3 - Article
VL - 26
SP - 307
EP - 315
JO - Human Reproduction
T2 - Human Reproduction
JF - Human Reproduction
SN - 0268-1161
IS - 2
ER -