The primary target audience is AUA members, urology residents and medical students, urology subspecialty fellows, members of the urologic care team, researchers, quality officers, government professionals, insurance company professionals, and health care professionals.
Summit Proceedings Paper
The AUA held its inaugural Quality Improvement Summit on Saturday, January 25, 2014. The conference focused on reducing infectious complications of transrectal needle biopsy. A series of speakers presented data on this growing problem; additionally several called attention to how their individual practices are combatting the issue. Following the event, a proceedings paper [pdf] was drafted to summarize the presentations and ensuing discussion.
White Papers Related to Prostate Needle Biopsy
- Optimal Techniques of Prostate Biopsy and Specimen Handling
- Prevention and Treatment of the More Common Complications Related to Prostate Biopsy Update
The Quality Improvement Summit was the first in a series to focus upon and address quality issues in urology. This inaugural event, which was held on January 25, 2014, addressed the timely topic of Prostate Needle Biopsy Complications and was organized into five main sections under the central theme of reducing complications associated with transrectal ultrasound (TRUS) prostate biopsies.
Our keynote speaker was Dr. Kate Goodrich, Group Director, Quality Measurement & Health Assessment Group for the Center for Clinical Standards and Quality at the Centers for Medicare & Medicaid Services (CMS).
Each section included several presentations followed by group discussions and consensus involving the panels and the audience. The final session was focused on quality measure creation from the topics discussed by all the panels and participants.
Quality Improvement Summit Presentations
- Timothy Averch – Introduction
- Chris Gonzalez – Prostate Needle Biopsy White Paper
- Chris Gonzalez – Rectal Swab Literature
- Michael Liss – Rectal Swab Implementation
- Stuart Wolf – Antibiotic Choices Guidelines
- Richard Watson – Antibotic Choices Literature
- James Montie – MUSIC
- Deepak Kapoor – Integrated Medical Professionals
- Michael Franks – Virginia Urology
- J. Stephen Jones – Cleveland Clinic
- Kate Goodrich – Keynote Presentation
- Christopher Tessier – Quality Measures
- Timothy Averch – Conclusion
Quality Improvement Summit Videos
- Introductory remarks by:
- Steven M. Schlossberg, MD
- Timothy Averch, MD
- Christopher Tessier, MD
- Explanation of the AUA/SUNA White Paper on the Incidence, Prevention and Treatment of Complications Related to Prostate Needle Biopsy
- Presentation by Christopher Gonzalez, MD (17:21)
- Group discussion (37:50)
- Discussion of the use of Rectal Swab
- Existing literature – Christopher Gonzalez, MD (44:45)
- Implementation – Michael Liss, MD (1:00:36)
- Group discussion (1:18:38)
- Discussion of Antibiotic Choices
- Guidelines – J. Stuart Wolf, Jr., MD (00:00)
- A Wiser Way to Win – Richard Watson, MD (10:50)
- Group discussion (26:23)
- Protocol Used by Existing Programs and Practices
- Michigan Urological Surgery Improvement Collaborative (MUSIC) – James Montie, MD (56:59)
- Large Urology Group Practice Association (LUGPA) & Advanced Urology Centers of New York – Deepak Kapoor, MD (1:11:30)
- Group discussion (1:26:40)
- Virginia Urology – Michael Franks, MD (1:28:16)
- Cleveland Clinic – J. Stephen Jones, MD (1:42:17)
- Group discussion (2:00:24)
- Keynote Speech by Dr. Kate Goodrich, Director of Quality Measures and Health Assessment, Centers for Medicare & Medicaid Services (CMS) Center for Clinical Standards and Quality (2:26:22)
- Question and answer session (3:11:56)
- Quality Measure Discussion – Christopher Tessier, MD and Timothy Averch, MD (00:00)
- Group Discussion (22:55)
The summit will be the first in a series that will focus upon and address quality issues in urology. This inaugural event will address the timely topic of Prostate Needle Biopsy Complications and is organized into five main sections under the central theme of reducing complications associated with transrectal ultrasound (TRUS) prostate biopsies. Each will have several presentations followed by group discussions and consensus involving the panels and the audience. The keynote speaker will be Dr. Kate Goodrich, Group Director, Quality Measurement & Health Assessment Group for the Center for Clinical Standards and Quality at the Centers for Medicare & Medicaid Services (CMS). The final session will focus on quality measure creation from the topics discussed involving all the panels and participants.
The purpose of this summit is to summarize the current understanding of quality improvements to prevent prostate needle biopsy complications. At the conclusion, the participants will be able to:
- Define the clinical problem of prostate needle biopsy complications and understand the risks according to the literature.
- Learn about the quality efforts by urologists from a various clinical environs towards minimizing complications in this scenario.
- Examine antibiotic choices to prevent infection after biopsy.
- Understand the various protocols of prostate needle biopsy in place in a multitude of clinical environments.
- Explore the literature and clinical implementation of rectal swab protocols.
For more information, contact quality@AUAnet.org.
Timothy David Averch, MD
Timothy D. Averch, MD, is professor of urology and director of Endourology at the University of Pittsburgh School of Medicine. He is also director of the UPMC Kidney Stone Center, whose members treat and manage kidney stone disease over the long term. Dr. Averch earned his medical degree from the University of Pittsburgh in 1989. Between 1989 and 1996, he completed surgical and urologic residencies at New York Medical College, and a fellowship in endourology at the Brady Urological Institute of Johns Hopkins Hospital. Before joining with UPMC in 2000, Dr. Averch was assistant professor of urology and director of Endourology at the Medical College of Virginia. His clinical interests include endourology, stone disease, and laparoscopic surgery. Additionally, Dr. Averch currently serves as Vice Chair of the AUA's Quality Improvement and Patient Safety Committee.
J. Quentin Clemens, MD, MSCI
J. Quentin Clemens, MD, MSCI, is Associate Professor of Urology and Director of the Division of Neurourology and Pelvic Reconstructive Surgery at the University of Michigan. Active with the AUA, he is the chair of the Data Committee, a member of the Health Policy Council, and former chair of the Quality Improvement and Patient Safety Committee. Additionally, he was named the 2008-2009 Gallagher Health Policy Scholar.
Dr. Clemens attended medical school at Johns Hopkins School of Medicine and completed his residency at Northwestern Memorial Hospital McGaw Medical Center.
His research interests are in the areas of epidemiology and health services research related to benign urologic diseases and quality of care assessment in urology. His areas of clinical expertise include videourodynamic evaluation of complex lower urinary tract dysfunction, surgical and nonsurgical management of female urinary incontinence and pelvic prolapse, management of complex fistulas and erosions, lower urinary tract reconstruction using bowel segments, bladder dysfunction due to neurologic disease, and urologic pain syndromes.
Michael Franks, MD
Since 2007 Michael Franks, MD, has been a member of the Virginia Urology Center in Richmond, VA, where he focuses on oncology. Prior to this, he served at the University of Pittsburgh Medical Center where he was Assistant Professor in the Department of Urology. Dr. Franks is a graduate of Towson State University and the University of Maryland School of Medicine. He completed both his general surgery and urology residencies at the University of Pittsburgh Medical Center. Additionally Dr. Franks was a Clinical and Research Fellow, Urologic Oncology Branch at the National Institutes of Health, National Cancer Institute and was an American Foundation for Urologic Disease Scholar.
Christopher M. Gonzalez, MD, MBA
Christopher Gonzalez, MD, MBA, is professor in the Department of Urology at the Northwestern University Feinberg School of Medicine. He received his degree in medicine from the University of Iowa School of Medicine, completed his residency at Northwestern Memorial Hospital and earned his master's degree in business administration at the Northwestern University Kellogg Graduate School of Business Management.
In addition to his role as faculty member and practitioner at Northwestern Memorial Hospital, he served as Chief of Urology at the Veterans Administration Lakeside division from 2003-2006. Dr. Gonzalez has also shepherded several community outreach programs, including a National Institutes of Health-funded pilot project involving prostate cancer screening and education among Hispanic men in Chicago, as well as the development of the International Surgical Relief Mission among the Northwestern Department of Urology staff.
Dr. Gonzalez is also very active with the AUA. He currently serves at the Vice Chair of Health Policy. Additionally, he was the 2010-2011 Gallagher Health Policy Scholar.
Kate Goodrich, MD<
Kate Goodrich, MD, is currently serving as the Group Director, Quality Measurement & Health Assessment Group (QMHAG) for the Center for Clinical Standards and Quality. Dr. Goodrich began serving as the Acting Director, QMHAG on August 20, 2012. The group is responsible for evaluating measurement systems to assess healthcare quality in a broad range of settings.
Dr. Goodrich was born and raised in Baton Rouge, LA. She received her B.S. in Molecular Biology from Rhodes College in Memphis, TN in 1991, and her MD from Louisiana State University Medical Center in Shreveport, LA in 1995. She moved to Washington, D.C. and completed her residency in Internal Medicine at George Washington University Medical Center (GWUMC), followed by a year as Chief Medical Resident. In July of 1999, she joined the faculty of GWUMC as a hospitalist in the Department of Medicine. A new Division of Hospital Medicine was created in 2005, and Dr. Goodrich was appointed Division Director. From 2005 to 2008 she expanded this division to 9 full-time hospitalists and started a Physician's Assistant hospitalist program. As Division Director, Dr. Goodrich shared responsibility for the Internal Medicine medical student and residency inpatient teaching program and initiated multiple patient safety and quality improvement projects. From 2003-2008 she served as Chair of the Institutional Review Board at GWUMC. In 2004 she founded the D.C. chapter of the Society of Hospital Medicine, and served as President for one year.
In July of 2008, Dr. Goodrich moved to New Haven, CT to start the Robert Wood Johnson Clinical Scholars Program at Yale University. Her research focused on the effect of transitions of care at hospital discharge for the elderly and other vulnerable populations, and the impact of hospitalist care on patient outcomes. In April of 2010 Dr. Goodrich came back to Washington, D.C. where she took a position as Medical Officer at the Department of Health and Human Services in the office of the Assistant Secretary for Planning and Evaluation (ASPE). She managed the portfolio of ASPE Comparative Effectiveness Research (CER) projects, including the creation of a multi-payer claims database for CER. She was the project manager for the HHS contract with the National Quality Forum in addition to overseeing other quality measurement projects at ASPE.
In September of 2011, Dr. Goodrich joined the Center for Medicare and Medicaid Services where she serves as a senior technical advisor to the Director of the Office of Clinical Standards and Quality and Chief Medical Officer of CMS. In this role, she provides leadership on quality measurement programs and oversees an HHS-wide effort to align measures across programs and with the private sector. Dr. Goodrich also serves as a CMS liaison with the National Quality Forum and participates in other quality improvement programs and efforts across CMS.
Dr. Goodrich continues to practice clinical medicine as a hospitalist at George Washington University Hospital. She is a clinical assistant professor of medicine in the Department of Medicine and serves as teaching faculty for the Internal Medicine residency, the medical school and the school of public health.
J. Stephen Jones, MD
Dr. J. Stephen Jones is the Chief of Surgical Operations for Cleveland Clinic Regional Hospitals and Professor of Surgery (Urology) at Cleveland Clinic Lerner College of Medicine at Case Western Reserve University (CWRU). He serves in several leadership roles at the Cleveland Clinic, including the Board of Governors. His specialty interests are in prostate and bladder cancer, for which he holds the Leonard Horvitz and Samuel Miller Distinguished Chair in Urological Oncology Research. He earned a Bachelor of Science in Zoology at the University of Arkansas and M.D. at UAMS. After residency at Vanderbilt University in 1992, he joined and became Chairman of the Springfield Clinic. He joined the Cleveland Clinic in 2001, becoming Department Chairman from 2007-2012. He received his MBA with honors from the Weatherhead School of Management at CWRU in May 2010.
Deepak A. Kapoor, MD
Deepak A. Kapoor, MD, is Chairman and CEO of Integrated Medical Professionals (IMP), PLLC, a multi-specialty physician group operating in the greater New York Metropolitan area. He received his BS magna cum laude from the Pennsylvania State University and his MD from Jefferson Medical College, in the Accelerated Five Year Honors Program. He completed his residency at Geisinger Medical Center, after which he served as Assistant Professor of Urologic Surgery at the University of Minnesota Medical Center. His medical background is diverse with both laboratory and clinical experience in the academic and private sectors. Dr. Kapoor's expertise includes basic science research in molecular biology as well as extensive experience in oncologic and reconstructive surgery. He continues to enjoy an active clinical practice along with his administrative duties with IMP.
Presently, Dr. Kapoor is Immediate Past President of the Large Urology Group Practice Association, Chairman of Access to Integrated Cancer Care (an informal advocacy group representing the rights of patients to access integrated services of the highest quality), Chairman of SCRUBS Mutual Assurance Company Risk Retention Group (the only national Urology specific medical malpractice carrier), a member of the Board of Directors of Allied Urological Services, (the largest lithotripsy partnership in the United States, where he also functions as Chairman of the Finance Committee) and is Founder and Past-President of the Integrated Medical Foundation. Prior to his tenure with IMP, Dr. Kapoor functioned as managing partner of Long Island Urological Associates. Additionally, Dr. Kapoor serves on a number of medical advisory boards including the New York State Governor's Prostate Cancer Advisory Panel.
Michael Liss, MD
Michael Liss, MD, is currently a clinical instructor at the University of California San Diego. He attended medical school at the Medical College of Wisconsin graduating with Honors in Research and completed internship and residency at the University of California Irvine. Microbiologic interests started as an undergraduate at Benedictine University where he participated in research at Argonne National Laboratory investigating microbes interaction with and oxidization of metal. He started research regarding prostate biopsy infection in 2008 and continues to investigate processes to prevent infection and improve antibiotic stewardship in the urologic community. Additionally, Dr. Liss serves on the AUA's Core Curriculum Committee.
James E. Montie, MD
Dr. James Montie completed his surgery training at The Cleveland Clinic Foundation and was on staff there for thirteen years. In 1991, he became the director of the Urologic Oncology Program at Wayne State University and Detroit Medical Center. Dr. Montie joined the faculty at the University of Michigan in 1995 as a professor of surgery in the urology section and became the chair of the Department of Urology in 1997. His clinical interests are in bladder and prostate cancer, and his clinical research has focused on developing new types of bladder replacement, investigating the perioperative risks and complications of radical cystectomy, and improving surgical outcomes after radical prostatectomy.
Christopher Tessier, MD
Christopher Tessier, MD, is a practicing clinician in Manchester, NH, and Chair of the AUA's Quality Improvement and Patient Safety Committee. He received his undergraduate degree from Muhlenberg College and his medical degree from Jefferson Medical College. He completed both his general and urology residencies at the Hospital of the University of Pennsylvania. Dr. Tessier received a Graduate Certificate in Medical Informatics from Oregon Health & Science University, and with this formal training he is engaged in the translation of specialty-specific evidence into clinical decision support and electronic quality measure formats. Additionally, he is a member of the American Medical Informatics Association. His interests include the development of quality measures from EHRs and clinical registry data, as well as usability and workflow issues related to electronic quality measure reporting for practicing clinicians.
Richard A. Watson, MD
Richard A. Watson, MD, is Director of Residency Training in Urology at the Hackensack University Medical Center in Hackensack, NJ. He is Professor of Urology Coterminous at the Rutgers New Jersey Medical School and Adjunct Associate Professor both of Urology and of Military Medicine at the Uniformed Services University of Health Sciences in Bethesda, MD. He is Professor of Urology at the New York Medical College. Colonel Watson served as a urologist in the United States Army for over 25 years. While on active duty, he took on a dynamic role in residency training, in clinical investigation and in combat readiness medical training at high levels of command.
Dr. Watson completed medical school at the Georgetown University School of Medicine and his internship at the Walter Reed Army Medical Center. His urology residency took place at the Tripler Army Medical Center in Honolulu, Hawaii.
J. Stuart Wolf Jr., MD
After receiving his MD degree from Northwestern University, Dr. J. Stuart Wolf Jr. completed the urology residency program at the University of California (San Francisco), followed by an Endourology/Laparoscopy Fellowship with Dr. Ralph Clayman in St. Louis. He joined the University of Michigan faculty in July of 1996 as the Director of the Division of Minimally Invasive Urology (now the Division of Endourology and Stone Disease), has co-directed the Urologic Oncology and Endourology/Laparoscopy Fellowship at the University of Michigan since 2002, and is the Associate Department Chair for Clinical Operations. Involved in professional activities at the regional, national and international levels, Dr. Wolf serves on the Executive Committee of the Michigan Urologic Society, is the Chair of the AUA Practice Guidelines Committee, and sits on the Board of Directors of the Endourological Society. Dr. Wolf's clinical practice focuses on urologic laparoscopy and endourology, and his research centers on the development of new techniques for laparoscopy and other minimally invasive procedures, and the critical assessment of such techniques within the spectrum of health care.