Technicity Index: A Quality Indicator to Improve Patient Care

Abstract

Introduction: Hysterectomy is a common gynecological procedure performed worldwide. Most of the international guidelines state that whenever feasible, they have to be performed vaginally or laparoscopically or with laparoscopic assistance as it is beneficial to patients. But majority are still being done by laparotomy. Minimally invasive surgery (MIS) is being widely adopted nowadays, and we need quality and performance indicators to analyze their benefits. One such indicator is technicity index (TI). Technicity is defined as the number of hysterectomies performed vaginally [non-descent vaginal hysterectomy (NDVH)] and laparoscopically [laparoscopic-assisted vaginal hysterectomy (LAVH) and total laparoscopic hysterectomy (TLH)] over the total number of hysterectomies performed in a particular health facility, in a year. Objective: To determine the TI from January 2014 to December 2018. Materials and methods: This was a retrospective, observational study in which the approach to all hysterectomies performed during January 2014 to December 2018 was recorded at Father Muller Medical College, Mangaluru. Hysterectomies done for obstetric indications and malignancies were excluded. The routes adopted for all types of hysterectomies were calculated, and the TI was calculated for every year. Results: In total, 2,268 hysterectomies were performed in 5 years, of which 222 (9.7%) were laparoscopic, 301 (13.27%) vaginal, and 1,745 (76.94%) total abdominal hysterectomies. The TI ranged from 17.21% to 29.11%. The average index for 5 years was 23.05%. Conclusion:Technicity index can be used to monitor shift toward minimally invasive procedures in our department. Assessing our level of care is necessary to effectively modify patient care. We can approach a higher TI by allocating resources to teach and provide MIS.

Designing a core data set for benign hysterectomy registration system and its implementation in a referral teaching hospital in Northwest Iran

“…The Technicity Index (TI) is a quality metric for hysterectomy, calculated by dividing the number of minimally invasive hysterectomies by the total number of hysterectomies performed during a specific period. A higher TI indicates better quality patient care [ 25 , 26 ]. A visual diagram also shows the frequency of hysterectomy indications and pathological findings.…”

The impact of laparoscopic gynecological surgery training on the technicity index of a developing country center

“…The host center is a world reference center, regarded as one of the birthplaces of modern laparoscopy, with a TI of 90%, a significant accomplishment when compared with the rate of the home center that is still under development 15 , 22 . Moreover, it is worth of note that, although TI calculation is most based on both vaginal and laparoscopic hysterectomies, only laparoscopic hysterectomies were included in our analysis in order to demonstrate the effect of training (otherwise, overall TI was 92.9% in the host center and 44.5% in the home center during the study period) ( Fig.…”

Technicity in Canada: A Nationwide Whole-Population Analysis of Temporal Trends and Variation in Minimally Invasive Hysterectomies

“…Reports of the technicity index have generally indicated improvement over time. In India, the technicity index increased from 20.1% in 2014 to 29.1% in 2018 [10]; in Australia, it increased from 58.4% in 2008-09 to 68.0% in 2016-17 [11]; and in the United States, it increased from 61.4% in 2010 to 71.7% in 2013 [12]. Although most reports of the technicity index have indicated improvement over time, globally reported figures still vary widely, ranging from 11% in Oman (2009) [9] and 29.1% in India (2018) [10] to 68.0% in Australia (2016) [11] and 71.7% in the United States (2013) [12], although many studies were based on single institutions and with variable study periods.…”