WASHINGTON, DC USA (UroToday.com) - One challenge is that urologists are not participating in efforts for collaborative quality improvement in urology. This is in part because surgical collaboratives are primarily focused on inpatient care, and most urology work in clinic based. Principles of quality collaboratives include collegiality, confidentiality, and effectiveness. His group started with trying to improve staging evaluations in men with newly diagnosed prostate cancer. There are documented practice variations in this regard and urologists control the ordering of staging evaluations. They looked to see if patients received bone scans initially, then provided feedback and disseminated NCCN guidelines. Across 3 practice groups that were evaluated, there was wide variation. The collaborative quality improvement initiative included audit and performance feedback and guidelines dissemination. Across all 3 practices, there were guideline appropriate changes in the ordering of staging tests. This provided proof of principle that urologists could participate in such an effort and alter practice patterns appropriately. A similar model was applied with bladder cancer and the use of immediate intravesical chemotherapy. This similarly showed practice improvements. There is an ongoing effort to have Blue Cross/Blue Shield fund further initiatives in this arena.
Presented by David Miller, MD, MPH at the Society for Basic Urologic Research (SBUR)/Society of Urologic Oncology (SUO) joint meeting during the American Urological Association (AUA) Annual Meeting - May 14 - 19, 2011 - Walter E. Washington Convention Center, Washington, DC USA
Reported for UroToday by Christopher P. Evans, MD, FACS , Professor and Chairman, Department of Urology, University of California, Davis, School of Medicine.
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