Guideline adherence in ectopic pregnancy management

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dc.contributor.authorMol, F.
dc.contributor.authorvan den Boogaard, E.
dc.contributor.authorvan Mello, N.
dc.contributor.authorvan der Veen, F.
dc.contributor.authorMol, B.
dc.contributor.authorAnkum, W.
dc.contributor.authorvan Zonneveld, P.
dc.contributor.authorDijkman, A.
dc.contributor.authorVerhoeve, H.
dc.contributor.authorMozes, A.
dc.contributor.authorGoddijn, M.
dc.contributor.authorHajenius, P.
dc.date.issued2011
dc.description.abstractBACKGROUND Evidence-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. METHODS A 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. RESULTS Out 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 (0–100%) existed between academic, teaching and non-teaching hospitals. CONCLUSIONS The 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.
dc.description.statementofresponsibilityF. 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, and P.J. Hajenius
dc.identifier.citationHuman Reproduction, 2011; 26(2):307-315
dc.identifier.doi10.1093/humrep/deq329
dc.identifier.issn0268-1161
dc.identifier.issn1460-2350
dc.identifier.orcidMol, B. [0000-0001-6887-0262] [0000-0001-8337-550X]
dc.identifier.urihttp://hdl.handle.net/2440/88492
dc.language.isoen
dc.publisherOxford University Press
dc.rights© The Author 2010.
dc.source.urihttps://doi.org/10.1093/humrep/deq329
dc.subjectHumans
dc.subjectPregnancy, Ectopic
dc.subjectRh Isoimmunization
dc.subjectChorionic Gonadotropin
dc.subjectRho(D) Immune Globulin
dc.subjectIsoantibodies
dc.subjectRetrospective Studies
dc.subjectPregnancy
dc.subjectAdult
dc.subjectGuideline Adherence
dc.subjectQuality Assurance, Health Care
dc.subjectQuality Indicators, Health Care
dc.subjectNetherlands
dc.subjectFemale
dc.subjectPractice Guidelines as Topic
dc.subjectSalpingectomy
dc.titleGuideline adherence in ectopic pregnancy management
dc.typeJournal article
pubs.publication-statusPublished

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