Michigan Urological Surgery Improvement Collaborative

Director: Khurshid Ghani, MD, MS


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The Michigan Urological Surgery Improvement Collaborative (MUSIC), established in 2011, is a physician-led quality improvement collaborative comprised of 44 urology practices and more than 250 urologists (90% of the urologists in the state). Initially the collaborative was designed to evaluate and improve the quality and cost efficiency of prostate cancer care for men in Michigan. While MUSIC continues its prostate cancer quality improvement effort, it has since expanded to kidney stone surgery, focusing on reducing operative complications from kidney stones (ROCKS); to make Michigan the #1 place for urologic care.

The vision of MUSIC is to be an innovator in physician-led quality improvement activities related to prostate cancer- and most recently urologic care in Michigan. By collecting clinically-credible data, comparing performance among our peers, sharing best practices, and implementing changes in clinical behavior, we are achieving more efficient utilization of healthcare resources, improving care delivery in our own environments, and enhancing the quality, value, and outcomes of treatment provided to men in Michigan with urologic care.

MUSIC participants focus their efforts on the following goals:

Prostate Cancer QI:

  • To improve patterns of care in the radiographic staging of men with newly diagnosed prostate cancer. Through comparative performance feedback and guideline dissemination, MUSIC aims to reduce unnecessary testing in many men at low-risk for metastatic disease and to optimize the use of appropriate radiographic staging evaluations among men with higher-risk cancers.
  • To understand repeat biopsy practice patterns, and reduce biopsy-related complications. Further, through the analysis of data and sharing of best practices, MUSIC looks to evaluate and understand repeat biopsy practice patterns, as well as reduce biopsy-related complications, for patients with prostate cancer, as well as those without the disease, but with HG PIN or ASAP.
  • To improve patient outcomes after radical prostatectomy, including functional outcomes. MUSIC aims to measure and improve radical prostatectomy outcomes through data collection, performance feedback, and sharing of best practices.
  • To improve patient-centered decision making among men considering local therapy for early-stage prostate cancer. MUSIC also seeks to use available patient decision aids to improve patient knowledge and participation in treatment decision-making for early-stage prostate cancer.
  • To enhance treatment appropriateness for men with newly-diagnosed prostate cancer. Through the development and implementation of specific appropriateness criteria for the use of active surveillance, MUSIC hopes to improve the appropriateness of treatment for men with newly-diagnosed prostate cancer.

Kidney Stones QI (initial aims):

  • To understand kidney stone practice patterns and decrease post-surgery complications and ED visit rates. MUSIC will also evaluate the cost attributable to post ED care procedures with the goal of reducing ED visits after Ureteroscopy and Shockwave Lithotripsy, two common kidney stone procedures. 

MUSIC leadership believes that achievement of these aims would significantly improve the quality and cost-efficiency of urologic care in the state of Michigan. The collective benefits of this effort will extend to urologists, Blue Cross Blue Shield of Michigan, and—most importantly—urologic care for patients.