Improving safety in intravesical therapy for high‐risk superficial bladder cancer

Abstract

Purpose

Intravesical therapy (IVeT) plays an increasingly important role in contemporary management of “high‐risk” superficial bladder cancer. Through audit this study aims to highlight points in patient care where improvements could be made. Based on preliminary audit data the authors developed a novel, integrated patient‐care pathway (ICP) to target areas of weakness. The impact of ICP implementation was then assessed prospectively.

Design/methodology/approach

The clinical course of 60 patients receiving IVeT was examined (34 men, 16 women; mean age: 73 years, range 52‐96). Complete data were available for 50 patients (mean follow‐up 51 months, range 6‐256; preliminary audit n=30, re‐audit n=20). In total 444 instillations of IVeT were administered.

Findings

Initial data highlighted several areas of deficiency including poor communication, inadequate urinalysis, low treatment compliance, delayed cystoscopic re‐evaluation and deficiencies in follow‐up. After implementation of the ICP, re‐audit confirmed marked improvements in all variables examined.

Practical implications

By rapid implementation of a simple, reproducible and comprehensive process of documentation the paper has demonstrated meaningful improvements in standards of care for this complex group of patients.

Originality/value

Through rigorous audit the paper identified areas of poor performance in the management of patients receiving IVeT. Using these data the authors modified clinical practice and strengthened the authors service provision for patients with “high‐risk” superficial bladder cancer.

Citation

Rajjayabun, P.H., Gould, J., Peterson, C., Pickford, D., Cooke, P.W. and Waymont, B. (2007), "Improving safety in intravesical therapy for high‐risk superficial bladder cancer", Clinical Governance: An International Journal, Vol. 12 No. 4, pp. 244-248. https://doi.org/10.1108/14777270710828919