The Quality Improvement Summit is focused on improving patient safety, ensuring appropriate use of advanced imaging and reducing associated costs. The day included didactic presentations, panel discussions, and question and answer sessions.
2018 Quality Improvement Summit: Opioid Stewardship in Urology
The 2018 Summit was held on Dec. 8, 2018 at AUA Headquarters in Linthicum, MD.
Access slide presentations, videos and resource materials below.
Speakers will include a combination of healthcare providers such urologists, anesthesiologists, plastic surgeons, and pain management and addiction specialists, in addition to researchers, policy makers and others.
After attending the 2018 Quality Improvement Summit, participants will be able to:
During the summit, there will be ample opportunity for audience participation. The cost to attend the QI Summit is $25 per attendee. Following the summit, a proceedings paper will be published.
The AUA is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The AUA designates this live activity for a maximum of 7.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
|Chad Brummett, MD||The Role of Physicians and Prescription Pharmaceuticals in the Opioid Epidemic [pdf]|
Physician-led Multicomponent Interventions in Opioid Stewardship
|Richard J. Barth, MD||Procedure-specific Opioid Prescribing Guidelines [pdf]|
|Jonah Stulberg, MD, PhD, MPH||Opioid Reclamation Efforts [pdf]|
|Jim Dupree, MD||MUSIC and Opioid Stewardship [pdf]|
Understanding Postoperative Pain
|Brooke Chidgey, MD||Pathophysiology of Post-operative Pain [pdf] |
|Meghan Sperandeo-Fruge, ND||Complementary Alternative Medicine Pain Management Strategies[ pdf]|
|Margaret Rukstalis, MD||Cognitive Behavioral Therapy and Other Non-Pharmacologic Approaches to Pain Management [pdf]|
Urology Perspectives: Challenging Urology Cases in Opioid Management
|Vernon Pais, MD||Kidney Stones: Impact on Prescription Opioid Use [pdf]|
|Matthew E. Nielsen, MD||The UNC Health Care System Opioid Stewardship Program [pdf]|
|Benjamin Davies, MD||Getting to Zero [pdf]|
High-Risk Patients and Exectations
|Behfar Ehdaie, MD||Expectation Setting for Opioid Prescribing [pdf]|
|Margaret Rukstalis, MD||A Surgeon's Role in the Management of Opioid Misuse Disorders [pdf]|
|Brooke Chidgey, MD||The Role of Pain Specialists for Managing High-Risk Patients [pdf]|
Policy and Outreach
|Jennifer Waljee, MD, MPH, MS||Opioid Education and Outreach [pdf] |
|Scott Winiecki, MD||Opioid Prescribing and the FDA Safe Use Initiative [pdf] |
|Gregory F. Murphy, MD, FACS*||Policy Change/Legislature to Address the Opioid Crisis [pdf]|
*Dr. Murphy was scheduled to participate in the Quality Improvement Summit but was unable to do so due to unforeseen issues.
Gregory Auffenberg, MD
Dr. Greg Auffenberg recently joined the Northwestern University Department of Urology after completing the clinical portion of a Society of Urologic Oncology fellowship at Memorial Sloan Kettering Cancer Center. Prior to that, he was at Northwestern University for both medical school and residency training in urology and earned a Master's at the University of Michigan in Health and Healthcare Research. His interests include researching care delivery and quality improvement in urologic oncology patients. He serves as a co-chair for the 2018 Quality Improvement Summit.
Timothy D. Averch, MD FACS
Dr. Timothy Averch graduated from the University of Pittsburgh School of Medicine and went on to complete his Urology training at New York Medical College. Following his residency, he completed a fellowship in Endourology at Johns Hopkins Hospitals. After faculty positions at the Medical College of Virginia and UPMC, Dr. Averch is now the Chief of Urology, Palmetto Health – University of South Carolina Medical Group. He is currently Chair for the AUA Quality Improvement and Patient Safety Committee.
Richard J. Barth, Jr., MD
Dr. Richard Barth attended Harvard Medical School and completed a residency in surgery at New England Deaconess Harvard Surgical Service. Additionally he was a fellow at the surgery branch of the National Cancer Institute. Dr. Barth is a Professor of Surgery at Dartmouth's Geisel School of Medicine and Chief of the Section of General Surgery at Dartmouth-Hitchcock Medical Center.
Tudor Borza, MD
Dr. Tudor Borza's research focus is on understanding how recent national policy changes have impacted surgical care and, more specifically, care of urologic malignancies. His current projects revolve around understanding the impact of PSA screening recommendations on detection and treatment patterns in prostate cancer. Additionally, he is working on understanding how different components of the Affordable Care Act have impacted treatment patterns and readmissions among patients undergoing major surgical procedures. Dr. Borza completed medical school at the University of Michigan and his residency in urology at Harvard. After completing a fellowship at the University of Michigan, he recently joined the University of Wisconsin, Department of Urology.
Chad Brummett, MD
Dr. Chad Brummett is the Director of the Division of Pain Research and, more broadly, is the Director of Clinical Research in the Department of Anesthesiology at the University of Michigan Medical School. His interests include predictors of chronic post-surgical pain as well as failure to derive benefit from interventions and surgeries done primarily for pain. He went to medical school at the University of Indiana and completed his residency at the University of Michigan Health System.
Brooke Chidgey, MD
Brooke Chidgey, MD is a board certified anesthesiologist in Chapel Hill, NC. She is affiliated with University of North Carolina Hospitals. Dr. Chidgey attended the University of Texas Medical School at San Antonio and completed her residency in anesthesiology through the University of North Carolina Hospitals. Additionally she completed a fellowship in pain management at Wake Forest University Baptist Medical Center.
Benjamin J. Davies, MD
Benjamin Davies, MD, is an Associate Professor of Urology at the University of Pittsburgh School Of Medicine. He is the Chief of the Urology Section at the Shadyside/Hillman Cancer Center, and also the Director of the Urologic Oncology Program. Dr. Davies obtained a medical degree at Mount Sinai Medical School in New York City. Following surgical and urologic residencies at the University of Pittsburgh, he did a post-doctoral fellowship in Urologic Oncology at the University of California, San Francisco. Dr. Davies was recently appointed to a faculty position in the Center for Pharmaceutical Policy in the Health Policy Institute. His interests have focused on drug shortages and pharmaceutical availability for patients. He has a long-standing interest in behavioral economics within the pharmaceutical industry.
James Dupree IV, MD, MPH
Jim Dupree, MD, MPH, assistant professor in Urology, received his medical and master of public health degrees from Northwestern University. He completed his Urology Internship/Residency at the McGaw Medical Center of Northwestern University and an advanced fellowship in Male Reproductive Medicine and Surgery at Baylor College of Medicine. Dr. Dupree has received the Leander W. Riba Award from Northwestern Memorial Hospital for outstanding clinical care, the Vincent J. O'Conor Jr. Award for excellence in teaching from Northwestern University, and the Men's Health Traveling Fellowship Award from the Society for the Study of Male Reproduction and Sexual Medicine Society, among others. Dr. Dupree specializes in the advanced treatment of male infertility, as well as testing and treating low testosterone and erectile dysfunction.
Behfar Ehdaie, MD, MPH
Dr. Behfar Ehdaie is an assistant attending in the Departments of Surgery (Urology Service) and Epidemiology and Biostatistics (Health Outcomes Group) at Memorial Sloan Kettering Cancer Center. His clinical expertise includes using minimally invasive techniques—laparoscopic, robotic, and image-guided therapies—for the treatment of urologic malignancies, with an emphasis on prostate cancer. Dr. Ehdaie is a graduate of the Georgetown University School of Medicine. He completed his urology residency training in 2010 at the University of Virginia Health System, then a three-year fellowship in urologic oncology at MSKCC and a Master of Public Health degree at the Harvard School of Public Health.
Gregory F. Murphy, MD
Dr. Greg Murphy is a urologist practicing in Greenville, NC. Additionally, he represents District 9 in the North Carolina General Assembly. He attended Davidson College and then medical school at the University of North Carolina. Prior to his appointment to the Assembly in November 2015, he was a member of the East Carolina University School of Medicine faculty and served as Chief of Staff of Vidant Medical Center.
Matthew Nielsen, MD MS FACS
Dr. Matthew Nielsen is a urologic oncologist at the Lineberger Comprehensive Cancer Center at UNC Chapel Hill, where he is Director of Urologic Oncology, Associate Professor of Urology and Adjunct Assistant Professor of Epidemiology and Health Policy and Management. Dr. Nielsen is involved in quality improvement and patient safety activities as a vice chair of the Quality Improvement and Patient Safety Committee of the AUA. Dr. Nielsen earned his medical degree at Johns Hopkins, where he remained for residency training at the Brady Urological Institute prior to joining the faculty at UNC.
Vernon M. Pais, Jr., MD
Dr. Vernon Pais is an Associate Professor of Surgery at the Geisel School of Medicine, Dartmouth University. His areas of focus include the evaluation and management of metabolic stone disease, kidney and ureteral stones, ureteral strictures, and urinary tract obstruction. He completed medical school and his residency at the University of Massachusetts Medical Center and a fellowship in endourology at Wake Forest University Baptist Medical Center.
Margaret Rukstalis, MD
Dr. Margaret Rukstalis is an addiction psychiatrist who has studied the brain and behavior change for over twenty-five years. She received her medical degree at Dartmouth Medical School, is currently on faculty at Wake Forest School of Medicine, and has coauthored more than fifty scientific articles and book chapters.
Angela B. Smith, MD, MS
Dr. Angela Smith received her medical degree from the University of North Carolina at Chapel Hill School of Medicine, where she also completed her urologic residency. After residency, Dr. Smith joined the UNC Department of Urology as an Assistant Professor. She is a board-certified urologist and member of the UNC Lineberger Comprehensive Cancer Center where she treats genitourinary malignancies, including bladder, prostate, kidney, and testicular cancer. Dr. Smith has a background in health services research and biostatistics with particular interests in patient-centered outcomes research, risk stratification, and quality of care for invasive bladder cancer. Dr. Smith is a co-chair of the 2018 Quality Improvement Summit.
Meghan Sperandeo-Fruge, ND
Dr. Meghan Sperandeo-Fruge received her undergraduate degree in biological sciences in 2003 from McNeese State University in Louisiana, with a minor in chemistry. While studying at National College of Natural Medicine (now NUNM) she completed a six-month mentorship in cardiovascular and pulmonary medicine. Following graduation, Dr. Sperandeo-Fruge was selected for a competitive teaching residency position at NUNM, where she spent two years teaching students and mentoring with a variety of naturopathic physicians. She is now a clinical supervisor at NUNM Health Center–Beaverton, teaching students clinical skills while conducting patient visits in a primary care setting. Dr. Sperandeo-Fruge also practices privately at The Center for Men's and Women's Urology in Gresham, Ore. There, she focuses her practice on a wide range of urology conditions in an integrative setting. She is also a trained holistic pelvic care provider.
Jonah Stulberg, MD, PhD, MPH
Jonah Stulberg is a General Surgeon and Health Services Researcher at Northwestern Memorial Hospital. He earned a PhD in Health Services Research with a concentration on Epidemiology and Biostatistics and a Master's in Public Health in Public Policy at Case Western Reserve University in Cleveland. He joined the Surgical Outcomes and Quality Improvement Center (SOQIC) at Northwestern in 2015. Dr. Stulberg is currently the Director of the Opioid Reduction Efforts and runs a Video-Based Learning Collaborative for the Illinois Surgical Quality Improvement Collaborative (ISQIC).
Jennifer F. Waljee, MD
Jennifer F. Waljee, MD, serves as an Associate Professor in the Section of Plastic and Reconstructive Surgery at the University of Michigan School of Medicine. She received her Bachelor of Science degree in Biology, and completed a Masters of Public Health Degree in Epidemiology at the University of Michigan. She then completed medical school at Emory University, and returned to the University of Michigan for her surgical training. She completed her General Surgery residency training in 2009, and spent an additional two years completing training in Plastic and Reconstructive Surgery at the University of Michigan. In 2012, she completed a fellowship in Hand Surgery, and joined the faculty in July 2012. Dr. Waljee is clinically focused on the treatment and reconstruction of all aspects of acute and chronic upper extremity conditions. Additionally, she has an interest in burn injuries and reconstruction, nerve injuries and neuropathies, spastic disorders, and inflammatory arthropathies.
Scott K. Winiecki, MD
Dr. Scott Winiecki received his medical degree from the University of Maryland School of Medicine and completed his pediatric training at the Children's Hospital of Philadelphia. After 12 years in private pediatric practice, he joined Food and Drug Administration in 2011. In 2012, he received the FDA's "Outstanding New Reviewer" Award for his work on thromboembolism following immune globulin products. In 2014, he received a Public Health Achievement Award for leading the first project at FDA to use Sentinel electronic data combined with medical record review to rapidly refine a safety concern. In September 2016, he joined the Safe Use Initiative at FDA, continuing his work in promoting patient safety and reducing preventable harm.
Opening Remarks - Gregory Auffenberg, MD (00:00)
The Role of Physicians and Prescription Pharmaceuticals in the Opioid Epidemic (12:00) - Chad Brummett, MD
Session 1: Physician-led Multicomponent Interventions in Opioid Stewardship
Procedure-specific Opioid Prescribing Guidelines (1:00:48) Richard J. Barth, MD
Opioid Reclamation Efforts (1:27:57) Jonah Stulberg, MD, PhD, MPH
MUSIC and Opioid Stewardship (1:49:34) Jim Dupree, MD
Session 2: Understanding Postoperative Pain
Pathophysiology of Post-Operative Pain (00:00) Brooke Chidgey, MD
Complementary Alternative Medicine Pain Management Strategies (15:58) Meghan Sperando-Fruge
Cognitive Behavioral Therapy and Other Non-Pharmacologic Approaches to Pain Management (41:34) Margaret Rukstalis, MD
Urology Perspectives: Challenging Urology Cases in Opioid Management
Introduction (1:17:05) Tudor Borza, MD
Kidney Stones Impact on Prescription Opioid Use (1:20:07) Vernon M. Pais, Jr., MD
The UNC Health Care System Opioid Stewardship Program (1:38:06) Matthew E. Nielsen, MD
Getting to Zero (1:49:18) Benjamin Davies, MD
Session 3: High-risk Patients and Expectations
Expectation Setting for Opioid Prescribing (00:00) Behfar Ehdaie, MD
A Surgeon's Role in the Management of Opioid Misuse Disorders (31:50) Margaret Rukstalis, MD
The Role of Pain Specialists for Managing High-Risk Patients (55:55) Brooke Chidgey, MD
Session 4: Policy and Outreach
Opioid Education and Outreach (1:15:38) Jennifer Waljee, MD, MPH, MS
Opioid Prescribing and the FDA Safe Use Initiative (1:37:54) Scott Winiecki, MD
Closing Remarks (2:06:08) Timothy Averch, MD
The AUA recognizes the importance of including residents and fellows in events, especially those related to quality improvement and patient safety. Therefore, a program has been established to promote resident and fellow involvement in the Quality Improvement Summit. Now in its second year, the program awarded travel scholarships to seven individuals who attended the 2018 Quality Improvement Summit. As part of the event's concluding activities, these individuals shared their reflections on the program and what lessons they learned.
Christi Butler, MD
Dr. Butler is currently in residency at University of California, San Francisco and is also working on a certificate in patient advocacy from the University of California, Los Angeles. She attended the Warren Alpert Medical School at Brown University and earned an undergraduate degree from Harvard University.
Julia Finkelstein, MD
Dr. Finkelstein earned her undergraduate degree from Cornell University and her medical degree from New York University School of Medicine. She took her residency training at the New York-Presbyterian Hospital/Columbia University College of Physicians & Surgeons. She is currently a pediatric urology fellow at Boston Children’s. She will earn a Masters in Public Health this spring from the Harvard T.H. Chan School of Public Health.
Elizabeth A. Green, MD
After earning an undergraduate degree in bioengineering from the University of Pennsylvania, Dr. Green attended medical school at Vanderbilt University. She continued her internship and residency training at Vanderbilt.
Tim Large, MD, MS
Dr. Large is an endourology fellow in the Department of Urology of the Indiana University Methodist Hospital. He also completed his residency and internship at the Indiana University Hospital. He attended medical school at Georgetown University where he also received a Masters degree in physiology and biophysics. He earned his undergraduate degree from the University of Wisconsin-Madison.
Vikram Madhavan Narayan, MD
Dr. Narayan is completing a urologic oncology fellowship at the University of Texas MD Anderson Cancer Center. He underwent his residency training at the University of Minnesota and obtained his medical and undergraduate degrees from the University of Florida.
Ruchika Talwar, MD
Dr. Talwar is taking her residency training at University of Pennsylvania, Penn Medicine Health System. She attended Rutgers New Jersey Medical School, which was part of a seven-year accelerated bachelor of arts/medical degree program with the New Jersey Institute of Technology, Albert Dorman Honors College, where she earned her undergraduate degree.
Anna M. Zampini, MD, MS, MBA
Dr. Zampini is finishing her residency at the Glickman Urological and Kidney Institute, Cleveland Clinic Foundation in Cleveland, OH. While attending Tufts University School of Medicine, she simultaneously earned a Master of Business Administration in Health Management from Brandeis University Heller School of Social Policy and Management. Additionally, Dr. Zampini has a Master of Science in Nutritional Biochemistry and Metabolism from the Tufts University Friedman School of Nutrition Science and Policy. She earned her undergraduate degree from the University of Guelph.
As part of the follow up of their experience, the recipients shared feedback on the Summit and quality improvement in general.