Quality-of-care framework in urological cancers: where do we stand?

TY - JOUR

T1 - Quality-of-care framework in urological cancers

T2 - where do we stand?

AU - Wang, Tim T

AU - Ahmed, Kamran

AU - Khan, Mohammed Shamim

AU - Dasgupta, Prokar

N1 - © 2011 THE AUTHORS. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.

PY - 2012/5

Y1 - 2012/5

N2 - What's known on the subject? and What does the study add? Provision of high-quality care necessitates the identification and measurement of relevant quality indicators. Urological surgery currently does not have a validated quality-of-care framework to guide surgical quality improvement. This article aims to delineate quality of care processes, current status of quality indicators for major urological cancers as well as recommend a provisional framework for evaluation of quality for urological procedures. Growing demands for patient safety, lower cost and quality of care have resulted in several initiatives of quality measurement across urological surgery. Although candidate indicators have been proposed in various procedures, the field still lacks a valid quality framework. Better understanding of the interplay between patient selection, surgical expertise, preoperative-, intraoperative, postoperative processes and outcomes is needed. Consensus needs to be achieved in which validated structural, process and outcomes measures to employ, how this data should be collected, which agencies to share this data with and how to use this data to effect change in health policy. Compliance with quality framework needs to be continuously audited with its outcomes frequently benchmarked against international standards. Pursuit of quality improvement schemes require significant investment and need to be weighed against current budgetary constraints.

AB - What's known on the subject? and What does the study add? Provision of high-quality care necessitates the identification and measurement of relevant quality indicators. Urological surgery currently does not have a validated quality-of-care framework to guide surgical quality improvement. This article aims to delineate quality of care processes, current status of quality indicators for major urological cancers as well as recommend a provisional framework for evaluation of quality for urological procedures. Growing demands for patient safety, lower cost and quality of care have resulted in several initiatives of quality measurement across urological surgery. Although candidate indicators have been proposed in various procedures, the field still lacks a valid quality framework. Better understanding of the interplay between patient selection, surgical expertise, preoperative-, intraoperative, postoperative processes and outcomes is needed. Consensus needs to be achieved in which validated structural, process and outcomes measures to employ, how this data should be collected, which agencies to share this data with and how to use this data to effect change in health policy. Compliance with quality framework needs to be continuously audited with its outcomes frequently benchmarked against international standards. Pursuit of quality improvement schemes require significant investment and need to be weighed against current budgetary constraints.

KW - Patient Safety/standards

KW - Quality of Health Care/standards

KW - Urologic Neoplasms/therapy

KW - Urology/standards

U2 - 10.1111/j.1464-410X.2011.10747.x

DO - 10.1111/j.1464-410X.2011.10747.x

M3 - Review article

C2 - 22077852

VL - 109

SP - 1436

EP - 1443

JO - BJU International

JF - BJU International

IS - 10

ER -