QUALITY IMPROVEMENT COLUMN by Adam Talenfeld


dataset to control for treatment selection bias, we performed multivariate regression analysis of 434 matched patients in the PA vs. PN cohort and 453 patients in the PA vs. RN cohort.


With a median follow-up of 47 months, we found no difference in overall or cancer-specific survival between percutaneous ablation and radical nephrectomy treatment groups through 6 years post intervention. PA was associated with half the odds of renal insufficiency compared to RN at 1-year follow-up (p=0.0015), one-fifth the odds of severe peri-operative complication compared to RN or PN (p<0.0001), and half the odds of 30-day a cardiovascular event compared to PN (p=0.0103).


Beginning its second 3-year cycle under a recently adopted system of rotating leadership, the Quality and Outcomes Division, now directed by Jeremy Collins, MD, and the Comparative Effectiveness Subcommittee are poised to continue promoting this growing area of research that offers an unprecedented vehicle with which to bring to light the tremendous impact interventional radiologists make in improving health outcomes. For information about the CE Subcommittee or the Quality and Outcomes Division of SIR Foundation, please contact Tresha Russell at trussell@sirweb.org.


References


1. cms.gov/Medicare/Quality-Initiatives-Patient-Assessment- Instruments/QualityInitiativesGenInfo/Downloads/


CMS-2016-Quality-Strategy-Slides.pdf, found at cms. gov/Medicare/Quality-Initiatives-Patient-Assessment- Instruments/QualityInitiativesGenInfo/CMS-Quality- Strategy.html, accessed 2/13/2016.


2. Agency for Healthcare Research and Quality (AHRQ) and the United States Department of Health and Human Services. Working for Quality: The National Quality Strategy. ahrq.gov/ workingforquality/about.htm#aims accessed 2/13/2016.


3. Itagaki MW, Talenfeld AD, Kwan SW, Brunner JWM, Mortell KE, and Brunner MC. Percutaneous Vertebroplasty and Kyphoplasty for Pathologic Vertebral Fractures in the Medicare Population: Safer and Less Expensive than Open Surgery. J Vasc Interv Radiol 2012;23:1423–9.


4. Kwan SW, Mortell KE, Talenfeld AD, and Brunner MC. Thermal ablation matches sublobar resection outcomes in older patients with early-stage non-small cell lung cancer. J Vasc Interv Radiol 2014;25:1–9.


5. Kwan SW, Mortell KE, Hippe DS, and Brunner MC. An economic analysis of sublobar resection versus thermal ablation for early-stage non-small cell lung cancer. J Vasc Interv Radiol 2014;25:1558-64.


* SIR Foundation grant, GE and AUR Radiology Research Academic Fellowship (AT) in coordination with an institutional CTSC grant (NIH/NCATS Grant #UL1TR00457).


Reputation management continued from page 15


Seize the power of the keyboard Dr. Miller emphasizes that Utah’s efforts are not intended to be punitive: “I said, ‘Look at all the great positive stuff patients are already saying.’ Plus, the best defense is a good offense. In the spirit of continuous improvement, you should know what your patients think of you.” Surveys are issued via email immediately after patients leave the doctor’s office, ensuring reliability of the source; response rates average 16 percent. Doctors have one week to review the comments before they are posted; the ratings and the survey are anonymous so there is no opportunity to identify the patient or practice service recovery. Although Utah neither incentivizes nor penalizes on the basis of survey results, coaching is available to physicians who have persistent low ratings in a certain area. Proactive training and support also are provided around specific survey skills, such as the


doctor’s ability to engage patients in a meaningful way that makes them feel valued and respected.


The process has only made the good better, says Dr. Miller. In 2009, 15 percent of Utah’s doctors were in the top 90th percentile nationwide; in 2015, 50 percent were. The average provider score is a 92, and the lowest-scoring provider is an 82.


“Don’t focus on the negative,” Dr. Miller advises. “Patients like their doctors and they tell you that. Focus on the good that you do. Patients are craving that information.”


Jennifer J. Salopek is a freelance writer in McLean, Virginia; she can be reached at jjsalopek@cox.net.


SPRING 2016 |


IR QUARTERLY 31


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