[Quality control plan for a primary bladder neoplastic process].
OBJECTIVE
Delays in the diagnosis and treatment of bladder cancer may change survival rates (6). We present the application of a plan for quality control in the management of primary bladder cancer, studying delays globally, and for individual indicators, as well as the impact of implemented improvement measures.


METHODS
We performed a retrospective chart review to detect problems appeared through the whole clinical management process in a population of patients undergoing surgery for primary bladder cancer in the Hospital Costa del Sol during 2001. Causes were studied and corrective measures established, application of which has been evaluated during the first semester of 2002. Study indicators encompass from delay time for first visit to delay time for radical surgical treatment.


RESULTS
Excessive average global delays for radical treatment of bladder tumor (208.3 days), and variability in the time to transurethral resection (one to 73.42 days) and to postoperative revision (54.4 days), were the most significant results. Evaluation of implemented measures shows a descent in global delays (134.2 days) and time to postoperative revision variability (32.4 days).


CONCLUSIONS
Application of quality control procedures for clinical management is essential in daily clinical practice, for systematic, continuous, and rigorous evaluation will allow us to offer patients a product that satisfies their personal and social expectations.
Area Integrada de Gestión de Urología-Diálisis, Hospital Costa del Sol. Marbella, Málaga, España. cmarchal@inicia.es
Cristóbal
C
Marchal Escalona
Miguel
M
Padilla León
Javier
J
García Penit
Jesús
J
Caballero Alcántara
D019090:Case Management / Q000592:standards*; D006801:Humans; D008499:Medical Records; D009367:Neoplasm Staging; D011786:Quality Control; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*