PD54-11 IMPLEMENTATION OF A STATE-WIDE QUALITY ASSURANCE INITIATIVE FOR PROSTATE MRI AND FUSION BIOPSY

You have accessJournal of UrologyImaging/Radiology: Uroradiology III (PD54)1 Apr 2020PD54-11 IMPLEMENTATION OF A STATE-WIDE QUALITY ASSURANCE INITIATIVE FOR PROSTATE MRI AND FUSION BIOPSY Madison Drye*, Anna Johnson, Ji Qi, Karla Witzke, Lindsay Zeeb, Andrew Luea, Patrick Gartland, Brian Lane, Kiran Nandalur, Rabia Martin, Matthew Davenport, David Miller, James Montie, Arvin George, and for the Michigan Urological Surgery Improvement Collaborative Madison Drye*Madison Drye* More articles by this author , Anna JohnsonAnna Johnson More articles by this author , Ji QiJi Qi More articles by this author , Karla WitzkeKarla Witzke More articles by this author , Lindsay ZeebLindsay Zeeb More articles by this author , Andrew LueaAndrew Luea More articles by this author , Patrick GartlandPatrick Gartland More articles by this author , Brian LaneBrian Lane More articles by this author , Kiran NandalurKiran Nandalur More articles by this author , Rabia MartinRabia Martin More articles by this author , Matthew DavenportMatthew Davenport More articles by this author , David MillerDavid Miller More articles by this author , James MontieJames Montie More articles by this author , Arvin GeorgeArvin George More articles by this author , and for the Michigan Urological Surgery Improvement Collaborative More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000956.011AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Rapid and widespread dissemination of prostate MR and fusion biopsy (FBx) has resulted in variation in quality of care due to radiologist, urologist, and technical factors. We aim to describe initial outcomes from the Michigan Urological Surgery Improvement Collaborative (MUSIC) MR/FBx quality assurance program as a novel framework for provider- and practice-level evaluation, feedback, and quality improvement. METHODS: The prospective MUSIC MRI/FBx registry was queried from 8/2017-9/2019 for imaging, patient, and pathology characteristics at the practice and provider level. Radiology and urology input informed development of a novel quality metric scorecard with benchmarking and target thresholds. Scorecards with anonymous peer comparator data were shared with radiology and urology practices and providers to inform performance and identify variation to be targeted with improvement activities (Figure 1). Ongoing quality improvement activities included FBx proctoring from expert users and on-site multidisciplinary reviews with radiologists, urologists, pathologists and staff. RESULTS: Data was collected on 5517 MRIs from 40 practices and 2375 fusion biopsies from 22 practices. Across all domains, the collaborative was in the benchmark range (green) or within 10% (yellow) but was >10% outside for PIRADS 5 ≥GG2 cancer detection rate (CDR). The sample practice demonstrated a PIRADS 5 CDR ≥10% outside the range (44%, red), potentially due to PIRADS misclassification, or targeting error/inadequate sampling during FBx. As a consequence, lower PIRADS 5 CDR likely impacted upgrading to high grade cancer by target (observed 17%, expected >20%). 4 MUSIC practices participated in proctoring, and 11 held multidisciplinary reviews of scorecards and discordant cases. Multidisciplinary review identified areas of improvement in MRI acquisition, interpretation, segmentation, co-registration during FBx, and targeting. CONCLUSIONS: The MUSIC MR/FBx scorecard serves as a robust framework for quality assessment and improvement centered on radiographic/pathologic correlation and strategic partnerships amongst stakeholders. It allows practices to track outcomes, aids in identifying deficiencies, and provides opportunities for additional training to improve the quality of prostate MRI and FBx. Source of Funding: Blue Cross Blue Shield of Michigan © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1108-e1108 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Madison Drye* More articles by this author Anna Johnson More articles by this author Ji Qi More articles by this author Karla Witzke More articles by this author Lindsay Zeeb More articles by this author Andrew Luea More articles by this author Patrick Gartland More articles by this author Brian Lane More articles by this author Kiran Nandalur More articles by this author Rabia Martin More articles by this author Matthew Davenport More articles by this author David Miller More articles by this author James Montie More articles by this author Arvin George More articles by this author for the Michigan Urological Surgery Improvement Collaborative More articles by this author Expand All Advertisement PDF downloadLoading ...