Striving for Quality Improvement in Community Practice

Monday, June 24, 2013

In a first of its kind study, a team of physicians at Grey Bruce Health Services review practice guidelines to better treat patients with prostate cancer.

The incidence and prevalence of prostate cancer has been increasing in Canada due in large part to increased public awareness. According to Canadian Cancer Statistics, prostate cancer remains the most common cancer diagnosed in men in Canada. More and more men are being screened for prostate cancer using prostate-specific antigen (PSA) and digital rectal examination.

In an attempt to improve the quality of care provided by urologists and pathologists involved in radical prostatectomies (RPs), Cancer Care Ontario (CCO) published an evidence –based guideline in the Canadian Urological Association Journal.  The guideline outlined predictors for biochemical failure and local recurrence.

In the first Canadian study of its kind, a team of physicians at Grey Bruce Health Services decided to review their hospital’s radical prostatectomy practice in order to compare their performance to the CCO guideline and published literature. The team would be the first to report outcomes for RPs in a community hospital setting.

The physicians reviewed all 133 patients who had a prostatectomy in 2006 and 2007. They found that their outcomes were quite favorable when compared to the literature.  Findings from the study suggest that a community hospital can appropriately select patients to undergo prostatectomy as well as achieve an acceptable rate of positive surgical margins. It was noted that in the Grey Bruce region, there was a high incidence of intermediate and high grade disease.

The team hopes that their study will serve as a resource for other Canadian community hospital urologists and pathologists who may wish to undertake a similar review.

“We applaud the effort and intentions of CCO in attempting to set out guidelines for optimizing the surgical management for patients undergoing radical prostatectomy for prostate cancer,” says Dr. Todd Webster, Urologist at Grey Bruce Health Services and lead researcher in the study. “Ongoing evaluation and reflective practice is essential to improving surgical outcomes and providing quality care.”

Click here to read the complete research paper published in the Canadian Urological Association Journal, December 2012.