Establishment of a urological surgery quality collaborative.

Area of Science:

• Urology
• Oncology
• Quality Improvement

Background:

• Prostate cancer diagnosis and staging are critical for treatment planning.
• Variations in staging practices can lead to overtreatment or undertreatment.
• Establishing collaborative networks can facilitate quality improvement initiatives.

Purpose of the Study:

• To describe the establishment of the Urological Surgery Quality Collaborative (USQC).
• To pilot a project aimed at improving radiographic staging for prostate cancer patients.
• To analyze baseline staging study utilization across different risk strata and practice locations.

Main Methods:

• The USQC involves over 60 urologists from 3 group practices.
• Uniform data, including prostate-specific antigen and clinical stage, were collected for newly diagnosed prostate cancer patients from May to September 2009.
• Patients were categorized into low, intermediate, and high-risk groups to analyze staging study use.

Main Results:

• Of 215 patients, 34% had low-risk, 42% intermediate-risk, and 24% high-risk prostate cancer.
• Bone scan and CT use increased significantly with cancer risk strata (17-18% for low risk to 88-86% for high risk).
• Staging study utilization varied significantly across USQC practices, particularly for low-risk patients.

Conclusions:

• Staging evaluation use in prostate cancer is influenced by cancer risk and practice location.
• Feedback of data to surgeons can improve practice patterns and reduce unnecessary staging in low-risk patients.
• The USQC provides a viable infrastructure for collaborative quality improvement in urological surgery.