QUALITY OF ADVANCED CANCER CARE IN AN INTEGRATED UROLOGY/PALLIATIVE CARE CLINIC 
Aaron Laviana*, Carol Bennett, Josemanuel Saucedo, Jonathan Bergman, Los Angeles, CA


INTRODUCTION AND OBJECTIVES: Quality of end-of-life care in the United States leaves significant room for improvement. Implementing interventions to improve the quality of care for individuals with advanced malignancies is vital to improving the value of the health care we deliver, and achieving success in a surgical clinic can uniquely inform future interventions to be pursued for broad implementation. The purpose of our study was to assess the quality of advanced cancer care in a multidisciplinary urology-palliative care clinic. 

METHODS: We partnered with patients, families, and palliative care clinicians to develop an integrated urology-palliative care clinic for patients with metastatic urologic malignancies. In an interim analysis, we abstracted medical records for the first 52 patients enrolled to assess quality of care in advanced cancer, based on quality indicators that have been previously developed and validated. We compared this with a representative national sample of patients in the Veterans’ Administration (VA). 


RESULTS: Our cohort was old (mean age, 67 years), male (100%), and had high comorbidity (mean Charlson Index Score, 3). The majority of men (84%) had metastatic prostate cancer, while the remaining had metastatic bladder (11%) or penile (5%) cancer. The patient’s primary care physician was integrated into the management of care in all cases. As shown in the table, quality of advanced cancer care was excellent.

 CONCLUSIONS: Quality of advanced cancer care in an integrated urology-palliative care clinic was excellent compared with a national VA sample. Efforts to implement similar interventions broadly within surgery are warranted