Cystectomy study underscores need for close communication between referring urologists, hospitals


"We're just trying to figure out ways to reduce our readmission rate, ways to reduce complications, and I think this is just a small step in doing that," says Randie White, MD.

In this video, Randie White, MD, shares the take-home message from the recent Urology Practice study, “Distance to Treatment with Radical Cystectomy in a Rural State: Long Car Rides, Equivalent Outcomes.” White is a urology resident at Maine Medical Center in Portland.


Is further research on this topic planned? If so, what will it focus on?

Yes, I think that's a good question. Currently, I think overall, we're trying to look at our readmission rates, trying to reduce our complications. In general, with this study, we would like to determine the effect of distance traveled on failure-to-rescue events. And again, looking at the effect of socioeconomic status on postoperative care, I think there's an element to that in this study and in the state of Maine as when patients are traveling far distances for care, a lot of them are coming from very rural parts of the state [and also] come from very different areas of the state than in a very urban center where we are located. We'd also like to look at the effect of having multiple urologic consultations on the effect of time to treatment and travel distance. I think we do have a lot more work to be done.

What is the take-home message for the practicing urologist?

I think for us, the importance of having this robust network and coordination of care with nurse navigators, support services, and having either, if you're an academic center, a close partnership with referring urologists, or if you are referring urologist, a close partnership with an academic center, patients who undergo radical cystectomy need a lot of support in the postop period. I think we're learning that more and more, in addition to the work we've done in this paper, we've tried very hard in the past year to update our discharge plans and tried to have really close communication with these patients moving forward after they're discharged as they are going back out into the community. And just making sure we're in close communication with them, with the referring urologists, with outside hospitals, to eliminate those barriers and try and prevent fragmentation of care.

Is there anything you would like to add?

I think again, like everyone, we're just trying to figure out ways to reduce our readmission rate, ways to reduce complications, and I think this is just a small step in doing that.

This transcript was edited for clarity.

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