Section of Endocrine Surgery, Department of General, Visceral and Transplant Surgery, University Medicine of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany.
Endocrine and Sarcoma Surgery Unit, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
Langenbecks Arch Surg. 2019 Nov;404(7):779-793. doi: 10.1007/s00423-019-01820-y. Epub 2019 Sep 7.
BACKGROUND/PURPOSE: A key measure to maintain and improve the quality of healthcare is the formal accreditation of provider units. The European Society of Endocrine Surgeons (ESES) therefore proposes a system of accreditation for endocrine surgical centers in Europe to supplement existing measures that promote high standards in the practice in endocrine surgery.
A working group analyzed the current healthcare situation in the field of endocrine surgery in Europe. Two surveys were distributed to ESES members to acquire information about the structure, staffing, caseload, specifications, and technology available to endocrine surgery units. Further data were sought on tracer diagnoses for quality standards, training provision, and research activity. Existing accreditation models related to endocrine surgery were included in the analysis.
The analysis of existing accreditation models, available evidence, and survey results suggests that a majority of ESES members aspire to a two-level model (termed competence and reference centers), sub-divided into those providing neck endocrine surgery and those providing endocrine surgery. Criteria for minimum caseload, number and certification of staff, unit structure, on-site collaborating disciplines, research activities, and training capacity for competence center accreditation are proposed. Lastly, quality indicators for distinct tracer diagnoses are defined.
Differing healthcare structures, existing accreditation models, training models, and varied case volumes across Europe are barriers to the conception and implementation of a pan-European accreditation model. However, there is consensus on accepted standards required for accrediting an ESES competence center. These will serve as a basis for first-stage accreditation of endocrine surgery units.
背景/目的：维持和提高医疗保健质量的关键措施是对服务提供者单位进行正式认证。因此，欧洲内分泌外科医师学会（ESES）提出了在欧洲建立内分泌外科中心认证体系的建议，以补充现有的促进内分泌外科高标准实践的措施。
一个工作组分析了欧洲内分泌外科领域当前的医疗保健状况。向 ESES 成员分发了两份调查，以获取有关内分泌外科单位的结构、人员配备、病例量、规范和可用技术的信息。还进一步寻求了质量标准、培训提供和研究活动的追踪诊断方面的数据。分析中纳入了与内分泌外科相关的现有认证模式。
对现有认证模式、现有证据和调查结果的分析表明，大多数 ESES 成员都渴望采用两级模式（称为能力和参考中心），分为提供颈部内分泌手术和提供内分泌手术的单位。提出了能力中心认证的最低病例量、员工人数和认证、单位结构、现场协作学科、研究活动和培训能力的标准。最后，还定义了不同追踪诊断的质量指标。
欧洲不同的医疗保健结构、现有的认证模式、培训模式以及不同的病例量是建立泛欧认证模式的概念和实施的障碍。然而，对于认证 ESES 能力中心所需的公认标准已经达成共识。这些将作为内分泌外科单位初步认证的基础。
