Safety and quality outcomes in peritoneal surface malignancy patients: developing a national center for excellence in Colombia.

Abstract

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS+HIPEC) is being used more frequently for the treatment of peritoneal surface malignancies. There are a paucity of data regarding safety and quality outcomes in this group of patients. The aim of this study was to evaluate safety events and quality measures in a group of patients who underwent CRS+HIPEC. All patients who underwent CRS+HIPEC procedures between December 2007 and March 2014 were included. All safety-related events and quality outcomes were reviewed. Major events were defined as occurrences in which there was harm to patient or healthcare personnel. Minor events were defined as quality or safety events in which there was potential for damage. A total of 72 patients were included. The mean Peritoneal Cancer Index for the study group was 20.5. One hundred percent compliance for informed consent, patient identification and surgical site marking, and antibiotic and venous thromboembolism prophylaxis guidelines was identified. The incidence of major safety events was 37.5%. Minor events occurred in 47.2% of patients. There was a 2.78% 30-day mortality in the study group. One in three patients undergoing CRS+HIPEC procedures experienced a major safety or quality event before, during, or after surgery. Adequate surgical care alone is not sufficient to prevent these occurrences. Active surveillance of safety events and quality leads to early detection and development of improvement plans. New CRS+HIPEC centers need to adhere to strict safety and quality guidelines to ensure excellent patient outcomes.