Researchers validate robotic cystectomy quality tool
In an effort to effectively measure quality of care and share best practices in surgical oncology, a team from Roswell Park Cancer Institute in Buffalo, NY developed a quality assessment tool and validated it in a study based on 10 years of prospectively collected data on robot-assisted cystectomies.
The study, published in Urology (2016; 97:124-9), revealed that centers that thoroughly track all aspects of care will better predict patient outcomes and improve patient care for those having their bladders removed.
“We’ve been seeing over the years that quality is becoming the primary driver for everything. A lot of things in bladder cancer didn’t depend on just the surgery, and the surgeon was just one piece of the puzzle. It’s really about the whole package,” lead author Khurshid Guru, MD, of Roswell Park Cancer Institute, told Urology Times. “It’s important to also consider disease severity, comorbidities, and other potentially modifiable aspects of care when evaluating surgical performance for a complex disease such as bladder cancer.”
Dr. Guru and his colleagues developed a measurement tool called the Quality Cystectomy Score (QCS) with the idea of predicting long-term outcomes.
The authors looked at 425 patients who underwent robot-assisted surgery between the 10-year period of 2005-2015 and rated each patient’s clinical outcome on a four-star scale that took into account demographics as well as everything from pre-op to post-op care. Factors including whether the surgery finished on time, whether a medical oncologist was consulted, the amount of blood loss, and what the complications of surgery were are considered in the score.
“We wanted to measure all these indicators so it would tell us how we’re doing. For any new procedure, I think it’s ideal to take metrics and make a dashboard,” Dr. Guru said. “A standardized quality-measurement approach such as the one we created and validated can help provider teams to assess their performance and can also identify areas for improvement, making this tool a valuable resource for patients, their families, and providers as they make important health care decisions.”