Breakthrough Improvement Collaborative for Ventral Mesh Rectopexy

Study Overview
=================
Brief Summary
-----------------
Different studies showed large variation between care processes in multiple diseases, this leads to large variation in outcomes. Better adherence to evidence-based guidelines for these diseases can reduce this variation and can improve the health outcomes. Ventral mesh rectopexy has gained popularity in Europe to treat different rectal prolapse syndromes. This procedure has been shown to achieve acceptable anatomic results with low recurrence rates, few complications, and improvements of both constipation and fecal incontinence. However, there is limited data on the care process and outcomes. Moreover, there is no insight in the variation between different centers for patients undergoing ventral mesh rectopexy. This study aims to map the variation in care for patients undergoing ventral mesh rectopexy in Flemish hospitals and to get an overview about the variation within and between these hospitals. Hereby, this will be a repeat of the studies for colorectal cancer, fragility hip fractures, stroke and breast cancer surgery.

Official Title
-----------------
BIC4VMR: Breakthrough Improvement Collaborative for Ventral Mesh Rectopexy

Conditions
-----------------
Rectal Prolapse

Intervention / Treatment
-----------------
* Other: Learning session 1
* Other: Learning session 2
* Other: Learning session 3


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Minimum age of 18 years; Elective admission for ventral mesh rectopexy Total rectal prolapse Grade III Internal prolapse with incontinence or obstructed defaecation Exclusion Criteria: Colpo posterior Patients diagnosed with severe dementia (DSM IV) or severe concomitant disease that may affect very short-term outcome (life expectancy less than 3 months) and hence influence deviations from standard acute care.

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: Learning session 1|Learn form international report, Explain key interventions, Explain BIC methodology, Retrospective patient record analysis, Team measures|
|Other: Learning session 2|Feedback report, Share (inter)national best practices, Discussion, set priorities, teaching and improvement, Retrospective patient record analysis|
|Other: Learning session 3|Feedback report, Share best practices, Discussion, set priorities, teaching and improvement, Retrospective patient record analysis, Team measures|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Length of stay | Number of days in the hospital | through study completion, an average of 4 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| In-hospital complication rate | Re-intervention, wound complications, surgical site infection, ileus and postoperative bleeding | through study completion, an average of 4 months | 
| in-hospital mortality | Mortality during hospitalization | through study completion, an average of 4 months | 
| 30 day readmission rate | Readmission rate within 30 days after discharge | through study completion, an average of 4 months | 
| 30 days mortality rate | Mortality rate within 30 days after discharge | through study completion, an average of 4 months |