Vaginal Hysterectomy Rates Before and After Implementation of a Multiple-Tier Intervention.
OBJECTIVE: To assess a multiple-tier intervention to increase vaginal hysterectomy rates.
METHODS: We performed a cohort study assessing hysterectomy performance before and after implementation of a multiple-tier intervention to increase vaginal hysterectomy rates at a single tertiary care medical center. This intervention involved resident and attending education and simulation, professional development, design of a clinical pathway to assist in hysterectomy decision making, and development of a surgical mentorship program.
RESULTS: Data from 698 hysterectomies (253 preintervention and 445 postintervention) were included. The preintervention time period extended from January 1, 2016, to December 31, 2017 (24 months), and the postintervention period from January 1, 2018, to February 28, 2020 (26 months). The intervention was implemented over the month of December 2017 but was not complete until January 1, 2018. The preintervention and postintervention cohorts were similar in most demographic and clinical aspects. Postintervention, the proportion of vaginal hysterectomies was higher (26.5% vs 5.5%, odds ratio 6.2, 95% CI 3.52-11.35), including in those performed for reasons other than prolapse (6.8% vs 0%, P
CONCLUSION: Implementation of a multiple-tier intervention was associated with an increase in vaginal hysterectomies.
Published In/Presented At
Crouss, T., Sharma, S., Smith, D., Hunter, K., Perry, R., & Lipetskaia, L. (2021). Vaginal Hysterectomy Rates Before and After Implementation of a Multiple-Tier Intervention. Obstetrics and gynecology, 137(4), 641–647. https://doi.org/10.1097/AOG.0000000000004318
Medicine and Health Sciences
Department of Obstetrics and Gynecology