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Urologists have largely been under the radar as the quality industry has focused on non-urologic diseases. That is rapidly changing.
In March, we discussed the challenges of measuring quality in a clinical practice ("The quest for quality: How to recognize and measure it"). Urologists have largely been under the radar as the quality industry has focused on non-urologic diseases. That is rapidly changing, as indicated by the following:
A problem with quality?
Most quality measures are processes or pathways-evidence-based medicine known to produce optimal outcomes-rather than measurements of the outcomes, according to Dr. Gaylis. Urologists are familiar with the challenges of measuring outcomes, but it is much simpler to measure processes. Our medical colleagues have been engaged in this effort for several years. Anyone who has served in a hospital leadership position recently is familiar with measures for community-acquired pneumonia, acute myocardial infarction, congestive heart failure, etc. These quality indicators measure how often evidence-based medicine was applied. Hospitals that are top performers are eligible for bonus payments from the Centers for Medicare & Medicaid Services.
What you can expect
The Surgical Care Improvement Project began in 2003 as a national program whose goal is to reduce the nationwide incidence of surgical complications by 25% by 2010. Urologists will be directly affected, and you can anticipate that closer scrutiny will occur with your hospitalized patients.