The AUA 2017 Quality Improvement and Patient Safety take-home messages also highlighted a QI project that led to reductions in catheter trauma rates and a QI program for robot-assisted radical prostatectomy that uses video clips.
Kristin L. Chrouser, MD, MPHThe AUA 2017 Quality Improvement and Patient Safety take-home messages also highlighted a QI project that led to reductions in catheter trauma rates and a QI program for robot-assisted radical prostatectomy that uses video clips. The take-homes were presented by Kristin L. Chrouser, MD, MPH, of the University of Minnesota, Minneapolis.
Notable Outcomes and Trackable Events after Surgery (NOTES), a MUSIC tool that identifies drivers of 30-day readmission after radical prostatectomy, found gastrointestinal events resulted in over half of readmissions, suggesting a high-impact opportunity for QI after RP.
Quality improvement (QI) involves the formal analysis of performance and a systematic effort to improve it. The Merit-based Incentive Payment System (MIPS), which marries earlier programs-the Physician Quality Reporting System, Value-Based Payment Modifier, and Meaningful Use-encompasses quality and practice improvement activities that will impact urologists’ bottom line. The MIPS score adjusts physician payment up or down.
American College of Chest Physicians guidelines for venous thromboembolism prophylaxis, which call for 28 days of enoxaparin postoperatively, is safe and effective in high-risk urologic oncology patients, with a 0% VTE rate and no complications after 30 days.
The Foley Project, a QI project that involves key stakeholders in catheter use, led to reductions in catheter trauma rates, need for subsequent procedures, and number of urology consults.
The Michigan MUSIC QI collaborative accrues practices and collects data, but also involves member urologists in meetings and QI initiatives that are integrated back into practice, making it a tool for QI, not just an up-to-date database. Surgeons are given reports on their perioperative outcomes, how they deviate from other surgeons within the collaborative, and their patients’ functional and oncologic outcomes.
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