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Observational Study
. 2022 Jul;37(7):1727-1738.
doi: 10.1007/s00384-022-04203-w. Epub 2022 Jul 2.

Emilia-Romagna Surgical Colorectal Cancer Audit (ESCA): a value-based healthcare retro-prospective study to measure and improve the quality of surgical care in colorectal cancer

Ilaria Massa  1 , Federico Ghignone  2 , Giampaolo Ugolini  2 , Giorgio Ercolani  3 , Isacco Montroni  4 , Patrizio Capelli  5 , Gianluca Garulli  6 , Fausto Catena  7 , Andrea Lucchi  8 , Luca Ansaloni  9 , Nicola Gentili  1 , Valentina Danesi  10 , Maria Teresa Montella  1 , Mattia Altini  11 ; ESCA Collaborative Group
Collaborators, Affiliations
Observational Study

Emilia-Romagna Surgical Colorectal Cancer Audit (ESCA): a value-based healthcare retro-prospective study to measure and improve the quality of surgical care in colorectal cancer

Ilaria Massa et al. Int J Colorectal Dis. 2022 Jul.

Abstract

Purpose: Surgery is the main treatment for non-metastatic colorectal cancer. Despite huge improvements in perioperative care, colorectal surgery is still associated with a significant burden of postoperative complications and ultimately costs for healthcare organizations. Systematic clinical auditing activity has already proven to be effective in measuring and improving clinical outcomes, and for this reason, we decided to evaluate its impact in a large area of northern Italy.

Methods: The Emilia-Romagna Surgical Colorectal Audit (ESCA) is an observational, multicentric, retro-prospective study, carried out by 7 hospitals located in the Emilia-Romagna region. All consecutive patients undergoing surgery for colorectal cancer during a 54-month study period will be enrolled. Data regarding baseline conditions, preoperative diagnostic work-up, surgery and postoperative course will be collected in a dedicated case report form. Primary outcomes regard postoperative complications and mortality. Secondary outcomes include each center's adherence to the auditing (enrolment rate) and evaluation of the systematic feedback activity on key performance indicators for the entire perioperative process.

Conclusion: This protocol describes the methodology of the Emilia-Romagna Surgical Colorectal Audit. The study will provide real-world clinical data essential for benchmarking and feedback activity, to positively impact outcomes and ultimately to improve the entire healthcare process of patients undergoing colorectal cancer surgery.

Clinical trial registration: The study ESCA is registered on the clinicaltrials.gov platform (Identifier: NCT03982641).

Keywords: Audit; Benchmarking; Colorectal cancer; Feedback; Quality improvement; Surgery.

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Conflict of interest statement

The authors declare no competing interests.

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
General and ESCA clinical auditing process
Fig. 2
Fig. 2
Case-mix adjusted data will be presented using funnel plots with a 95% confidence interval
See this image and copyright information in PMC

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