Guideline adherence in ectopic pregnancy management

F. Mol, E. Van Den Boogaard, N. M. Van Mello, F. Van Der Veen, B. W. Mol, W. M. Ankum, P. Van Zonneveld, A. B. Dijkman, H. R. Verhoeve, A. Mozes, M. Goddijn, P. J. Hajenius

Research output: Contribution to journalArticle

9 Citations (Scopus)

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.

LanguageEnglish
Pages307-315
Number of pages9
JournalHuman Reproduction
Volume26
Issue number2
DOIs
Publication statusPublished - 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

Mol, F., Van Den Boogaard, E., Van Mello, N. M., Van Der Veen, F., Mol, B. W., Ankum, W. M., ... Hajenius, P. J. (2011). Guideline adherence in ectopic pregnancy management. Human Reproduction, 26(2), 307-315. https://doi.org/10.1093/humrep/deq329
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. / Guideline adherence in ectopic pregnancy management. In: Human Reproduction. 2011 ; Vol. 26, No. 2. pp. 307-315.
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Mol, F, Van Den Boogaard, E, Van Mello, NM, Van Der Veen, F, Mol, BW, Ankum, WM, Van Zonneveld, P, Dijkman, AB, Verhoeve, HR, Mozes, A, Goddijn, M & Hajenius, PJ 2011, 'Guideline adherence in ectopic pregnancy management', Human Reproduction, vol. 26, no. 2, pp. 307-315. https://doi.org/10.1093/humrep/deq329

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 journalArticle

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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.

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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.

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Mol F, Van Den Boogaard E, Van Mello NM, Van Der Veen F, Mol BW, Ankum WM et al. Guideline adherence in ectopic pregnancy management. Human Reproduction. 2011 Jan 1;26(2):307-315. https://doi.org/10.1093/humrep/deq329