The Cedars-Sinai Urology Progam monitors a number of measures in its ongoing commitment to the quality of care it gives to patients. These measures include the volume of procedures done, average length of hospital stay and complication rate. In addition to clinical care, patient satisfaction with their experience is also monitored.
Studies suggest that for many surgical procedures, hospitals that perform high volumes have better quality outcomes, i.e. lower short-term and long term mortality and morbidity. Volume is an indicator of experience, which influences outcomes in multiple ways. In addition to the experience of surgeons in performing specific procedures, high volume hospitals may institute specific care processes that improve outcomes and have the infrastructure dedicated to particular clinical specialties, including related technology and intensive care personnel. Commitment to quality standards throughout the institution is also an important determinant of better outcomes.1,2 In addition, outcomes for high-risk procedures have been shown to be better when performed by more highly-trained surgeons than by general surgeons.3
The chart below shows the volume for inpatient urology procedures performed at Cedars-Sinai over the past 3 years.
|Inpatient Procedures Performed||2012||2013||2014|
|Transuretheral Removal Ureteral Obstruction||109||96||87|
|Closed Renal Biopsy||102||88||95|
|Transuretheral Destruction of Bladder Lesion||57||48||36|
*Management of prostate cancer at Cedars Sinai has been changing. More patients with prostate cancer are being managed with active surveillance rather than local therapies such as surgery or radiation.
Length of Stay
The table below compares the observed or actual number of days that a patient undergoing a urology procedure at Cedars-Sinai spent in the hospital to the expected length of stay for a clinical similar patient population at other academic medical centers across the country,
A shorter length of stay is generally better than a longer one.
|*Radical Prostatectomy||1.7 days||1.8 days|
|Nephroureterectomy||3.4 days||3.8 days|
|Transurethral Prostatectomy||3.7 days||3.4 days|
|Ureteral Catheterization||4.7 days||4.7 days|
|Transuretheral Removal Ureteral Obstruction||4.3 days||4.2 days|
|Closed Renal Biopsy||4.6 days||4.4 days|
|Transuretheral Destruction of Bladder Lesion||7.9 days||6.1 days|
|Partial Nephrectomy||3.7 days||4.1 days|
The graph below compares the percentage of cases treated at Cedars-Sinai who experienced selected complications. These complications are defined by the Agency for Healthcare Quality and Research (AHRQ) and include events such as post-operative hemorrhage, respiratory failure, etc.For more information and a complete listing, click here.
A lower complication rate is better than a higher one.
|Transuretheral Removal Ureteral Obstruction||3.4%|
|Closed Renal Biopsy||2.1%|
|Transuretheral Destruction of Bladder Lesion||5.6%|
The data comes from the University HealthSystem Consortium (UHC), an alliance of more than 300 of the nation’s non-profit academic medical centers and their affiliated hospitals. The majority of these facilities participate in UHC's Clinical DataBase/Resource Manager. The data were accessed on April 4, 2014 for patients discharged during 2014.
1Bach PB, Ann Intern Med 2009; 150:729-30
2Greene FL, Ann Surg Oncol 2007; 15:14-15
3Kozower BD et al, Ann Thorac Surg 2009; 86:1405-08