Surgical Oncology, Cancer Care Ontario, ON, Canada.
HPB (Oxford). 2007;9(5):330-4. doi: 10.1080/13651820701611234.
Many studies have shown an association between both surgeon and hospital operative procedure volumes and outcomes, particularly operative mortality. It is also recognized that volume is only one of a number of factors, including 1) surgeon training and experience, and 2) hospital resources, organization, and processes of care, which can also influence outcomes. The Surgical Oncology Program at Cancer Care Ontario has included hospital volumes in a set of standards for the conduct of major pancreatic cancer surgery, along with recommendations for surgeon training and hospital resources, organization, support services, and processes of care to encourage regionalization of major HPB surgery. Cooperation with these recommendations was encouraged by the public reporting of mortality data and by an educational program directed at both surgeons and senior administrators in Ontario hospitals with the support of the provincial health ministry. The provincial mortality rate from major pancreatic cancer surgery has decreased by more than 50% since the introduction of this program.
许多研究表明，外科医生和医院手术量与手术结果之间存在关联，尤其是手术死亡率。人们也认识到，手术量只是影响手术结果的众多因素之一，这些因素包括：1）外科医生的培训和经验；2）医院资源、组织和护理流程。外科肿瘤项目在安大略省癌症护理中心将医院的手术量纳入了一系列进行大型胰腺癌手术的标准中，同时还为外科医生培训以及医院资源、组织、支持服务和护理流程提出了建议，以鼓励大型肝胆手术的区域化。通过公布死亡率数据以及在省级卫生部门的支持下，为安大略省医院的外科医生和高级管理人员提供教育项目，鼓励外科医生合作实施这些建议。自从实施该项目以来，大型胰腺癌手术的省级死亡率已经下降了 50%以上。
