Page 8 - Ovarian Cancer Surgery - Quality Indicators-Summary

QI 7 - PRE-, INTRA-, AND POST-OPERATIVE MANAGEMENT

TYPE Structural indicator.
DESCRIPTION
The minimal requirements are: (1) intermediate care facility, and access to
SPECIFICATIONS an intensive care unit in the center are available, (2) an active perioperative
management program is established(1).
TARGET(S) Numerator: not applicable.
SCORING RULE Denominator: not applicable.

Not applicable.

3 if the minimal requirements are met.

(1)Details of perioperative management includes (non-exhaustive list): preoperative hemoglobin optimization and iron deficit correction;
correction of denutrition and immunonutrition according the current guidelines; fluid management, involving a Goal Directed Therapy
(GDT) policy rather than liberal fluid therapy without hemodynamic goals. However, the superiority of GDT compared to restrictive fluid
strategy remains unclear. There is no recognized standard method of monitoring; pain management, including in the absence
of contra-indication the use of epidural analgesia in order to avoid opioids; while routine premedication is no longer recommended,
prevention of postoperative nausea and vomiting should be systematic.

QI 8 - MINIMUM REQUIRED ELEMENTS IN OPERATIVE REPORTS

TYPE Process indicator.
DESCRIPTION
Operative report is structured. Size and location of disease at the beginning of
SPECIFICATIONS the operation must be described. All the areas of the abdominal cavity(1) must
be described. If applicable, the size and location of residual disease at the end of
TARGET(S) the operation, and the reasons for not achieving complete cytoreduction must be
SCORING RULE reported.

Numerator: number of patients with advanced ovarian cancer undergoing cytore-
ductive surgery who have a complete operative report that contains all required
elements as defined above.
Denominator: all patients with advanced ovarian cancer undergoing cytoreductive
surgery.

90%.

3 if the target is met

(1)ovaries, tubes, uterus, pelvic peritoneum, paracolic gutters, anterior parietal peritoneum, mesentery, peritoneal surface of the colon
and bowel, liver, spleen, greated and lesser omentum, porta hepatis, stomach, Morrison pouch, lesser sac, undersurface of both
hemidiaphragms, pelvic and aortic nodes and if applicable pleural cavity.

8 • ADVANCED (STAGE III-IV) OVARIAN CANCER SURGERY - QUALITY INDICATORS •