Quality assessment is surgical care is very important, though very difficult. With this thesis we attempted to overcome the limitations of currently used quality indicators and developed a dynamic... Show moreQuality assessment is surgical care is very important, though very difficult. With this thesis we attempted to overcome the limitations of currently used quality indicators and developed a dynamic, unique quality assessment tool to reflect upon individual surgical performance with case-mix correction.To substantiate the development of this new quality instrument, the implementation of laparoscopic hysterectomy in the Netherlands and in residency program was assessed, relevant case-mix characteristics for laparoscopic hysterectomy were explored, several ways to monitor surgical quality were analyzed and attempts were made to make quality registries less comprehensive for clinicians. Subsequently, patient risk factors in laparoscopic hysterectomy were identified to enhance patient safety and finally to improve the surgical quality of laparoscopic hysterectomy. Show less
