Measuring the Quality of Care at the Cedars-Sinai Center for Minimally Invasive Gynecologic Surgery

Physicians in the Center for Minimally Invasive Gynecologic Surgery have combined surgical volume with state of the art technology to safely perform complex procedures like hysterectomies.

Comparing Hysterectomy Rates Performed Laparoscopically and Using a Traditional Open Approach at the Cedars-Sinai Center for Minimally Invasive Gynecologic Surgery

In a study examining the three surgical approaches to performing a hysterectomy (abdominal, vaginal or laparoscopic), the benefits of the minimally invasive laparoscopic approach compared to the abdominal approach included speedier return to normal activities, less bleeding during surgery, shorter hospital stay and fewer infections. 1, 2

This cross-sectional analysis of the 2014 Nationwide Inpatient Sample3, among 229,260 hysterectomies demonstrates that physicians at the Cedars-Sinai center have performed laparoscopic hysterectomies at a rate that significantly higher than the national average. 

Cedars-Sinai Center for Minimally Invasive Gynecologic Surgery
  U.S. Average Cedars-Sinai
Percentage of Hysterectomies Performed for Benign Conditions 2014 2014 2015 2016
Laparoscopically 23.5% 39.6% 39.8% 40.6%
Abdominally 66.4% 33.4% 35.0% 55.4%
Vaginally 10.1% 27.0% 25.2% 4.0%

1 Nieboer TE, Johnson N, Lethaby A, et al. Surgical approach to hysterectomy for benign gynaecological disease. Obstetrics and Gynaecology, 2009 Jul 8;(3):CD003677.
2 ACOG Committee Opinion  No. 444: choosing the route of hysterectomy for benign disease. Obstet Gynecol, 2009 Nov;114(5):1156-8.
3 HCUP Nationwide Inpatient Sample (NIS), 2013, Agency for Healthcare Research and Quality (AHRQ), based on data collected by individual states and provided to AHRQ by the states.  

Volume and Average Length of Stay for Hysterectomy Patients Treated at the Cedars-Sinai Center for Minimally Invasive Gynecologic Surgery

This quality measure refers to the average number of days a patient stays at Cedars-Sinai Medical Center after being admitted for a hysterectomy. The goal is to ensure that all patients are appropriately treated in the hospital for their respective conditions and are not hospitalized longer than necessary. Studies show that patients who spend less time in the hospital after surgery will have fewer complications.4,5,6

As detailed in the chart below, laparoscopic hysterectomies performed by physicians at the Cedars-Sinai center resulted in a consistently shorter length of stay, currently less than the national average.
 

Procedure Volumes and Average Length of Stay at the Cedars-Sinai Center for Minimally Invasive Surgery in 2015 Volume Average Length of Stay (In Days) 7 Expected Length of Stay (In Days)
Laparoscopic Hysterectomies 142 1.27 2.52
Abdominal Hysterectomies 194 3.23 2.93
Vaginal Hysterectomies 14 2.00 2.36
Total 350


Rotter T, Kinsman L, James E, et al. Clinical pathways: effects on professional practice, patient outcomes, length of stay and hospital costs. Department of Public Health, Dresden Medical School, University of Dresden, Dresden, Germany, D-01307, 2010 Mar 17;3:CD006632.
5 Becker ER. National trends and determinants of hospitalization costs and lengths-of-stay for uterine fibroids procedures. J Health Care Finance, 2007 Spring; 33(3):1-16.
6 Pearson SD, Kleefield SF, Soukop JR, et al. Critical pathways intervention to reduce length of hospital stay. Am J Med, Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care; and the Division of General Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA, 2001 Feb 15;110(3):175-80.
7 Expected length of stay is calculated by UHC based on patients with similar clinical characteristics. The University Health Consortium (UHC) more than 300 of the nation’s non-profit academic medical centers and their affiliated hospitals. The majority of these facilities participate in UHC's Clinical DataBase/Resource Manager. Cases with malignancy are excluded.