The diagnosis and management of endometriosis

- Clinical Quality Indicators for Monitoring

Here we will put 3 - 5 quality standards that can be measured and here is what are quality standards and how to write them:

Measuring and monitoring quality of care is recognized as a tool for improving health services and outcomes by healthcare payers and providers throughout the world.

Measuring clinical quality standards in healthcare facilities assesses many aspects of healthcare provided specifically assessing health outcomes, clinical processes, patient safety, efficient use of health care resources, care coordination, and adherence to clinical guidelines.

We will concentrate on data that can be obtained from the INPATIENT file of the patient.

A CQS has two main components:

1- A quality statement (QS): a clear and concise sentence taken from the strong recommendations describing high-priority areas.

2- A quality measure (QM). a quantitative measure of care quality or service provision specified in the quality statement, and comprise any of three components: structure, care process or outcome measure. Quality measures, for process and outcome are specified in the form of a numerator and a denominator which define a proportion (numerator/denominator). The numerator is assumed to be a subset of the denominator population. For structures, the quality measure is evidence of what the statement refers to.

◾ Treatment
QS.1	Clinicians should use imaging (US or MRI) in the diagnostic work-up, acknowledging that a negative result does not exclude superficial peritoneal disease.
QM.1	Percentage of women with suspected endometriosis who undergo imaging as part of diagnostic work-up, regardless of prior negative imaging.
QS.2	Offer hormone treatment (CHCs, progestogens, GnRH agonists or antagonists) as an option for reducing endometriosis-associated pain.
QM.2	Percentage of patients with endometriosis-associated pain who are offered hormone therapy.
QS.3	Prescribe combined hormonal add-back therapy with GnRH agonists to prevent bone loss and hypoestrogenic symptoms
QM.3	Percentage of patients receiving GnRH agonists who also receive add-back therapy.
QS.4	Perform cystectomy rather than drainage and coagulation during ovarian endometrioma surgery.
QM.4	Percentage of ovarian endometrioma surgeries in which cystectomy is performed.
QS.5	Do not routinely use extended GnRH agonists before ART, as benefit is uncertain.
QM.5	Percentage of women undergoing ART who are not given pre-treatment GnRH agonists without clear indication
QS.6	Avoid routine surgery for ovarian endometrioma before ART due to potential harm.
QM.6	Percentage of women with endometrioma undergoing ART without unnecessary pre-ART surgery
QS.7	Do not routinely perform surgery before ART in women with rASRM stage I/II endometriosis.
QM.7	Percentage of early-stage endometriosis patients who proceed to ART without prior surgery
QS.7	Do not routinely excise or ablate asymptomatic incidental endometriosis during surgery.
QM.7	Percentage of incidental asymptomatic cases not undergoing surgical excision