Performance Measurement and Quality Improvement Initiatives for Bladder Cancer Care.

Abstract:

PURPOSE OF REVIEW:Bladder cancer care is costly due to long surveillance periods for non-muscle-invasive bladder cancer (NMIBC) and comorbidities associated with the surgical treatment of muscle-invasive bladder cancer (MIBC). We reviewed current evidence-based practices and propose quality metrics for NMIBC and MIBC. RECENT FINDINGS:For patients with NMIBC, we propose four categories of candidate quality metrics: (1) appropriate use of imaging, (2) re-staging transurethral resection of bladder tumor, (3) perioperative intravesical chemotherapy, and (4) induction and maintenance BCG in high-risk NMIBC. For patients with MIBC, we propose eight candidate quality measures: (1) neoadjuvant chemotherapy, (2) multidisciplinary consultation, (3) urinary diversion teaching, (4) appropriate perioperative antibiotics, (5) venous thromboembolic prophylaxis, (6) lymphadenectomy, (7) monitoring of complications, and (8) inclusion of enhanced recovery after surgery protocols. Marked variation in evidence-based practice exists among patients with bladder cancer and represents opportunity for quality improvement. Regional and national physician-led collaboratives may be the best vehicle to achieve quality improvement in bladder cancer.

journal_name

Curr Urol Rep

journal_title

Current urology reports

authors

Ristau BT,Smaldone MC

doi

10.1007/s11934-018-0856-2

subject

Has Abstract

pub_date

2018-10-24 00:00:00

pages

100

issue

12

eissn

1527-2737

issn

1534-6285

pii

10.1007/s11934-018-0856-2

journal_volume

19

pub_type

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