For a study, researchers wanted to evaluate the efficacy of a multi-tiered strategy to improve vaginal hysterectomy rates. At a single tertiary care medical center, the researchers conducted cohort research to compare hysterectomy performance before and after implementing a multi-tier intervention to boost vaginal hysterectomy rates. The intervention included resident and attending education and simulation, professional development, creating a clinical route to aid in the decision-making process for hysterectomy, and creating a surgical mentorship program.
The study contained 698 hysterectomies (253 pre-intervention and 445 post-intervention). The pre-intervention phase lasted 24 months, from January 1, 2016, to December 31, 2017, while the post-intervention period lasted from January 1, 2018, to February 28, 2020 (26 months). The intervention began in December 2017; however, it was not completed until January 1, 2018. The pre-intervention and post-intervention populations were identical in most demographic and clinical features. The percentage of vaginal hysterectomies conducted after the intervention was greater (26.5% vs. 5.5%, odds ratio 6.2, 95% CI 3.52–11.35), including those performed for reasons other than prolapse (6.8% vs. 0%, P<.001). According to logistic regression, prolapse, uterine weight less than 250 g, and surgery during the post-intervention group were all substantially linked with vaginal hysterectomy. The surgical complications did not change considerably depending on the kind of hysterectomy. A multi-tiered strategy was linked to an increase in vaginal hysterectomies.
