Clinical auditing as an instrument to improve care for patients with ovarian cancer: The Dutch Gynecological Oncology Audit (DGOA)

Abstract

Introduction: The Dutch Gynecological Oncology Audit (DGOA) was initiated in 2014 to serve as a nationwide audit, which registers the four most prevalent gynecological malignancies. This study presents the first results of clinical auditing for ovarian cancer in the Netherlands. Methods: The Dutch Gynecological Oncology Audit is facilitated by the Dutch Institute of Clinical Auditing (DICA) and run by a scientific committee. Items are collected through a web-based registration based on a set of predefined quality indicators. Results of quality indicators are shown, and benchmarked information is given back to the user. Data verification was done in 2016.Results: Between January 01, 2014 and December 31, 2018, 6535 patients with ovarian cancer were registered. The case ascertainment was 98.3% in 2016. The number of patients with ovarian cancer who start therapy within 28 days decreased over time from 68.7% in 2014 to 62.7% in 2018 (p < 0.001). The percentage of patients with primary cytoreductive surgery decreased over time (57.8%e39.7%, P < 0.001). However, patients with complete primary cytoreductive surgery improved over time (53.5%e69.1%, P < 0.001). Other quality indicators did not significantly change over time. Conclusion:The Dutch Gynecological Oncology Audit provides valuable data on the quality of care on patients with ovarian cancer in the Netherlands. Data show variation between hospitals with regard to pre-determined quality indicators. Results of 'best practices' will be shared with all participants of the clinical audit with the aim of improving quality of care nationwide.

Audit on gynecological surgeries in AL-Zahraa University Hospital in year 2017

“…Audit of all gynecological procedures as one of the commonest operations performed in medical practice is not routinely done in developing countries. Clinical audit is one of the fundamental principles of clinical governance, the process by which clinicians improve the quality of the care they provide and it also help to direct resource allocation, and can serve to improve clinical response and outcomes [5] .Therefore, this work was carried out to audit the gynecological operations that was performed at Al-Zahraa University Hospital during the year of 2017 to assess their indications, complications and days of hospital stay for each type of operations.…”

Incomplete Surgical Staging in Clinical Early-Stage Ovarian Cancer: Guidelines Versus Daily Practice

“…In 2014, the Dutch Gynecological Oncology Audit (DGOA) was initiated to serve as a nationwide audit, which registers the four most prevalent gynecological malignancies [24]. Based on these data, benchmarked information based on quality indicators is given back to the user.…”

Guideline adherence in ovarian cancer for surgical staging in the Netherlands

“…All patients with ovarian cancer who had a surgical staging as registered in the Dutch Gynecological Oncology Audit between January 1, 2015 and December 31, 2019 in the Netherlands were included. The Dutch Gynecological Oncology Audit is a population-based clinical quality registry initiated in 2014 13. Registering patients in the Dutch Gynecological Oncology Audit has been mandatory for all patients with an ovarian malignancy since 2014.…”

“…In practice, this meant that patients who were eligible for either a staging procedure or cytoreductive surgery should be referred to a center specializing in ovarian cancer. As a consequence, the number of hospitals providing this surgical care reduced gradually over time from 90 in 2010 to 20 in 2020 13. These are ovarian cancer-specialized center hospitals (one per region) and ovarian cancer-specialized general teaching hospitals (0–2 per region).…”

“…Moreover, a systematic review of surgical staging in ovarian cancer recognized formal quality improvement programs resulting in high-volume centers as an important tool to improve quality of care 1. A similar initiative was initiated in the Netherlands in 2014—the Dutch Gynecological Oncology Audit 13. Since 2016 a quality indicator has been developed for surgical staging of clinical early-stage ovarian cancer derived from the Dutch Gynecological Oncology Audit dataset 14.…”