Inpatient Urology Program

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.

Procedure Volumes

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

2011

2012

2013

 *Radical Prostatectomy 253 196 162
  Nephroureterectomy 146146 157
 Transurethral Prostatectomy 227224 154
 Ureteral Catheterization7469 105
 Transuretheral Removal Ureteral Obstruction110109  96
 Closed Renal Biopsy77102 88
 Transuretheral Destruction of Bladder Lesion 5757 48
 Partial Nephrectomy5753 46

*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 graph below compares the observed or actual number of days that a patient undergoing a urology procedure at Cedars-Sinai spent in the hospital. This is compared with the length of stay for patients treated at other academic medical centers and their affiliates across the country.

A shorter length of stay is generally better than a longer one.

 

Complications

The graph below compares the percentage of cases treated at Cedars-Sinai who experienced selected complications. This is compared with the length of stay for patients treated at other academic medical centers and their affiliates across the country.  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.

*The data are from the University HealthSystem Consortium (UHC), an alliance of 120 academic medical centers and 301 of their affiliated hospitals representing the nation's leading academic medical centers. Most of these facilities participate in UHC's Clinical DataBase/Resource Manager. The data were assessed on March 21, 2014 based on patients discharged in 2013

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