AUA 2022 Quality Improvement Summit

The American Urological Association’s 2022 Quality Improvement (QI) Summit was a three-part program that focused on a critical issue in medicine today – the use of palliative care for patients with advanced benign and malignant urologic diseases.

In-Person Session

Laying the Foundation for Primary Palliative Care in Urology

May 15, 2022 | New Orleans, LA

Nationally recognized speakers explored best practices and strategies for developing and implementing a primary palliative care intervention for patients with urologic conditions. The in-person session of the summit focused on six primary objectives:

  • To describe strategies that would allow urologists and palliative care clinicians to co-manage patients in a sustainable fashion, given the current palliative care clinician shortage
  • To create a health services research, policy, and dissemination agenda that advances urologist-palliative care partnerships to ensure that all aspects of care are adequately addressed among those with advanced disease
  • To design a quality-improvement intervention that can be implemented at participating sites after the conference is completed
  • To reach a consensus on outcomes and metrics related to assessment, collaboration, and funding for a primary palliative care intervention for urology
  • To outline strategies for implementing agreed-upon best practices to comprehensively address patient needs in advanced disease states
  • To create a framework to develop content and community to meet the needs of the urological community regarding palliative care principles.

Speaker Bios

John L. Gore, MD, MS


John L. Gore, MD MSHS is a Professor in the Department of Urology at the University of Washington School of Medicine and Affiliate Investigator at the Fred Hutchinson Cancer Research Center. He is Program Director for the University of Washington SUO Fellowship in Urologic Oncology. His clinical expertise is in urologic oncology. His methodologic expertise is in health services research including surgical outcomes research, patient-centered outcomes research, comparative effectiveness research, and quality of life.

Jonathan Bergman, MD, MSHS


Jonathan Bergman, MD, MPH is an Associate Professor of Urology and Family Medicine and Associate Program Director at UCLA. As the Chief of Bioethics at the West LA VA and the Chair of the Urology-Primary Care workgroup at LA County-DHS, he has an interest in health systems, population health, and medical education. He also works on integrating palliative care into the management of urological patients to address the needs of patients with advanced disease.

Matthew Nielsen, MD, MS


Matthew Nielsen, MD serves as the Rhodes Distinguished Professor and Chair of the Department of Urology at the University of North Carolina at Chapel Hill.  Dr. Nielsen is deeply invested in quality improvement and patient safety. Locally, he has served as Associate Director of the UNC Institute for Healthcare Quality Improvement and Director of Quality for the UNC Faculty Physicians and received the UNC Physician Friend of Nursing Award in 2017. He is active in this space on a national level with the American Urological Association as Chair of the Quality Improvement and Patient Safety Committee and Chair-elect of the Science and Quality Council. In addition, he has served the American College of Physicians' Performance Measurement Committee and High Value Care Task Force.

Micheal Darson, MD

Dr. Darson is a senior physician with Arizona Urology Specialists, a United Urology Group member. Dr. Darson is the Chair of the AUA’s Practice Management Committee. He also serves on the AUA’s Coding and Reimbursement Committee and serves as the CRC liaison to the AUA’s Quality Improvement and Patient Safety Committee. Dr. Darson received his BS in pharmacy from The Ohio State University. Dr. Darson earned his medical degree from Wright State University in Dayton, Ohio and completed his urology residency at the Mayo Clinic Graduate School of Medicine in Rochester, Minnesota. Dr. Darson’s interests lie in general urology with emphasis on BPH and minimally invasive techniques to treat BPH.

Pauline Filippou, MD


Pauline Filippou, MD is a Society of Urologic Oncology Clinical Fellow at the University of Washington in Seattle, Washington. She is a graduate of the University of California, San Diego (BS), the University of California, San Francisco School of Medicine (MD), and completed her urology residency at the University of North Carolina, Chapel Hill. During her fellowship research year, she was supported by the SUO and Urology Care Foundation Research Scholars grant to conduct health-services research investigating usage patterns of palliative care and hospice services amongst urologic oncology patients, with the ultimate goal of seamlessly fusing palliative care and urologic oncology in practice and research. 

Karleen Giannitrapani, PhD, MPH

Dr. Karleen F. Giannitrapani is the Co-Director of the VA Quality Improvement Resource Center for Palliative Care, supporting Geriatrics and Extended Care programs in 170 VA hospitals nationally. She is also an Instructor at Stanford University School of Medicine Primary Care and Population Health, section of Palliative Medicine, and a Core Investigator at the VA Health Services Research and Development Center for Innovation to Implementation. She has a 5-year VA Career Development Award on building better teams across disciplines and was a 2020 Research Scholar with the American Academy of Hospice and Palliative Medicine for related work. She is co-I or PI on over 30 million dollars of competitive federal funding and has palliative care research collaborations around the globe including the India, Australia, and Ethiopia.  She has a PhD in Health Policy and Management with a focus on Organizational Behavior, a Master of Community Health Sciences, a Master of African Studies, and a Bachelor of Anthropology and Religion. Her methods expertise are in team science, implementation science, quality improvement methods, and design. Her upcoming work engages diverse patients and caregivers in co-design and evaluation of serious illness care interventions. She broadly aims to bridge the gaps in care processes between palliative care and surgeons to improve care quality and patient experience. She became involved with the AUA through participating in the advanced grant writing cohort for early career investigators to develop a pilot of perioperative palliative care for diverse patients with urologic cancers.

 

Scott Gilbert, MD, MS

Dr. Gilbert is a Senior Member in the Departments of Genitourinary Oncology and Health Outcomes & Behavior at the H. Lee Moffitt Cancer Center & Research Institute. His clinical practice is focused on surgical and multidisciplinary management of bladder, kidney and testis cancer. Dr. Gilbert has a special interest in patient-reported outcomes and quality of life research. His research has been supported by the American Urological Association Foundation, the American Cancer Society, and the National Cancer Institute.

Jaime Goldberg, MSW, LCSW

Jaime Goldberg, MSW, LCSW is currently a full-time PhD student at the University of Wisconsin-Madison School of Social Work, studying aging and palliative care. Ms. Goldberg’s research interests center around addressing the health care needs of complex family systems during serious illness and at the end of life, and enhancing interprofessional education for health care professionals to address such needs.

 

Ms. Goldberg currently teaches communication and health care decision-making courses through the University of Maryland-Baltimore Master of Science Program in Palliative Care. She previously served as social work specialist for the Cedars-Sinai Supportive Care Medicine team and palliative care social worker for the Veterans Administration Greater Los Angeles Inpatient Palliative Care Consultation service. She was a member of the core faculty for the Palliative Medicine Fellowship Program at both institutions. Ms. Goldberg earned her Master of Social Work from Washington University in St. Louis.

Joshua Hauser, MD

Joshua Hauser is Associate Professor of Medicine and Medical Education and Palliative Medicine Fellowship Director at Northwestern Feinberg School of Medicine. He practices palliative care at Northwestern Memorial Hospital and at the Jesse Brown VA Medical Center, where he is section chief for palliative care. Dr. Hauser directs the Education in Palliative and End of Life Care (EPEC) Program, a 20 year old train-the-trainer program designed to teach primary palliative care skills to clinicians of all disciplines and backgrounds. The EPEC Program has adapted its curriculum to multiple specialties and settings of care, including EPEC-Oncology, EPEC-Emergency Medicine, EPEC-Pediatrics, EPEC for Veterans and EPEC-Neurology. EPEC has also been taught internationally in the Middle East, Thailand, Nigeria and India. EPEC was cited as a key palliative care continuing education program in the National Academy of Science 2015 report, Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life. In addition to general palliative care education, Dr. Hauser has educational interests in medical humanities and bioethics and overall professional development for medical students and trainees of all levels.

Lee Hugar, MD, MSCR

Lee A Hugar, MD, MSCR is a Society of Urologic Oncology fellow at the Moffitt Cancer Center and Research Institute in the Department of Genitourinary Oncology. He completed his urologic surgery residency at the University of Pittsburgh Medical Center. He is a graduate of The Pennsylvania State University (BS) and Emory University School of Medicine (MD, MSCR). Hometown: Orchard Park, NY. Professional interests include health services research, surgical education, and humanitarian surgery. As a urologic oncology trainee, he strives to develop a wealth of experience treating genitourinary cancer, anticipating and treating complications or sequelae of therapy, and navigating complex disease recurrences or progression. Most importantly, he is passionate about pursuing cure when feasible and improving patients’ quality of life throughout their course of disease.

Bruce Jacobs, MD, MPH

Bruce Jacobs, MD is an Assistant Professor in the Department of Urology and Associate Program Director of the Urologic Oncology Fellowship at the University of Pittsburgh Medical Center. He is also the Research Chief of the Health Services Research Division in the Department of Urology. He completed his fellowship training in health services research, urologic oncology, and laparoscopy/endourology at the University of Michigan. His research interests generally focus on improving the access, delivery, and quality of urologic care. 

Kevin Koo, MD, MPH, MPhil

Kevin Koo, MD, MPH, MPhil, is a urologist at Mayo Clinic and assistant professor of urology at the Mayo Clinic College of Medicine and Science. He specializes in the medical and surgical management of urinary stone disease. His research focuses on patient-centered design and evaluation of new technologies that can enhance surgeon and patient safety and strengthen trainee performance. A frequent contributor to the medical press, Dr. Koo is social media editor of the Journal of Surgical Research and serves on the editorial board of Urology Practice. He is an alumnus of the AUA H. Logan Holtgrewe Legislative Fellowship program and serves on the board of directors of the AUA Political Action Committee. A graduate of the Yale School of Medicine, he completed urology residency at Dartmouth-Hitchcock Medical Center and fellowship at the Johns Hopkins University School of Medicine.

John Leppert, MD, MS

Dr. Leppert completed his B.A. and M.D. through the combined Honors Program in Medical Education at Northwestern University. Dr. Leppert developed a passion for kidney surgery and completed his internship in general surgery and urology residency at UCLA. He remained at UCLA to complete a fellowship in Endourology and Minimally Invasive Surgery. In 2008, Dr. Leppert joined the Stanford University Department of Urology. As a staff surgeon and Director of Urologic Oncology at the Veterans Affairs Palo Alto Health Care System (VAPAHCS) he staffs multidisciplinary clinics caring for Veterans with complex cancers and kidney stones, and performs open, laparoscopic, and robotic cancer surgery.

Karl Lorenz, MD, MSHS

Dr. Karl Lorenz, MD, MSHS is a general internal medicine and palliative care physician, and Section chief of the VA Palo Alto-Stanford Palliative Care Program. Formerly at the VA Greater Los Angeles and UCLA, Dr. Lorenz directs palliative care research at the VA Center for Innovation to Implementation and serves as a member of the VA’s national Hospice and Palliative Care Program (HPC) leadership team and as Director of the operational palliative care Quality Improvement Resource Center (QuIRC). Under Dr. Lorenz’s leadership, since 2009 the Quality Improvement Resource Center (QuIRC) has served as one of three national leadership Centers responsible for strategic and operational support of the VA’s national hospice and palliative care programs. QuIRC develops and implements provider facing electronic tools for the VA’s national electronic medical record to improve the quality of palliative care.

Farnoosh Nik-Ahd, MD

Farnoosh Nik-Ahd, MD is a third year Urology resident at UCSF. She has various research focuses, including frailty and surgical outcomes, transgender healthcare outcomes, and disparities affecting women in urology. She studied Women’s Studies and Neuroscience at UCLA, and attended UCLA for medical school as well. She hopes to ultimately pursue a career in academic medicine in order to continue her research and help mentor the next generation of urologists, particularly women entering the field. In her free time, she enjoys traveling, painting, and spending time with family. 

Desiree Sanchez, MD

Dr. Desiree Sanchez was born and raised in Delano, California and graduated from the University of California, Los Angeles with a degree in Psychobiology. She then worked in a neuropathology translational medicine laboratory before attending medical school at the University of Washington, Seattle. During medical school, she spent two years doing research in vascular surgery and developed the very first vascular surgery research database at UWSOM. Her clinical and research interests center on healthcare delivery to the underserved, which will be the focus of her research year work with Dr. Stanley Frencher at the Martin Luther King Hospital at UCLA. She is still deciding which type of fellowship she would like to pursue after residency.

Scott Shreve, DO

Dr. Shreve is National Director of the Hospice and Palliative Care Program for the Department of Veterans Affairs and the Veteran Engagement Center. He is responsible for all policy, program development, staff education, and quality assurance for palliative and hospice care provided or purchased for enrolled veterans. He led a major initiative to change the culture of care for veterans with serious illness and to assure reliable access to quality palliative care. Half his time is committed to clinical care of veterans as Medical Director and Teaching Attending at a 17-bed unit at the Lebanon VA Medical Center and Penn State’s College of Medicine.

Anne Suskind, MD, MS

Dr. Anne M. Suskind, MD, MS, FACS, FPMRS is an Associate Professor of Urology at the University of California, San Francisco (UCSF), where she serves as the Associate Chair of Academic Affairs and Diversity, Equity & Inclusion (DEI) and as the Chief of Neurourology and Female Pelvic Medicine and Reconstructive Surgery (FPMRS).  She graduated with a BA in Anthropology from Haverford College (2001) before attending medical school at Albany Medical College (2006).  She then completed her urology residency at the University of Connecticut in 2011 and went on to complete two fellowships (in FPMRS and Health Services Research) and a Master’s Degree in Clinical Research Design and Statistical Analysis at the University of Michigan (2014).  Dr. Suskind’s clinical interests lie in the treatment of complex lower urinary tract disorders including neurogenic bladder, overactive bladder, and urinary incontinence.  Her research focuses on the impact of frailty in older adults undergoing urologic surgery, and she has received funding from the National Institutes of Health (NIH) in the form of R01, R03, K12, and T32 grants.  She also serves as the Chair of the Ethics Committee for the International Continence Society (ICS), on the Executive Board for the Society of Women in Urology (SWIU) and for SUFU, as an Assistant Editor for the Journal of Urology and on the Editorial Board for Urology Practice.

 

Martha Terris, MD

Dr. Martha K. Terris received her general surgery training at Duke University and urologic surgery training at Stanford University. Her urologic oncology fellowship training, also at Stanford, focused on prostate cancer diagnosis and staging. After completion of training in 1995, she remained at Stanford as faculty member in the Department of Urology and Chief of Urology at the Palo Alto Veterans Affairs Medical Center. Dr. Terris joined the faculty at the Medical College of Georgia and the Augusta Veterans Affairs Medical Center in 2002 as Professor of Urology. Dr. Terris assumed the position of Program Director for the Urology Residency Training Program in 2003. She has served as a member of the Urology Residency Review Committee as well as president of the Society of University Urologists and the Society of Urology Chairs and Program Directors. Dr. Terris became Chair of the Division of Urology and was awarded the Witherington Distinguished Chair of Urology in 2011. She is currently serving as Trustee for the American Board of Urology.

QI Summit Scholars

Daniel Au, MD
The University of Kansas Medical Center

Daniel Au, MD is a current 5th year urology resident at the University of Kansas Medical Center. He completed his undergraduate degree at the University of California Los Angeles in 2009 and medical school at Saint Louis University School of Medicine in 2017.  After completion of his residency training in June of 2022, he will join The Oregon Clinic to begin practice in Portland, Oregon.

Kelly Bree, MD
MD Anderson Cancer Center

 

Dr. Bree is a second year urologic oncology fellow at MD Anderson in Houston, TX. Her research interests include clinical and health services research in bladder cancer. She also has special interests in quality improvement projects aimed at improving perioperative care to patients with urologic malignancies.  

 

Pauline Filippou, MD
University of Washington 

Pauline Filippou, MD is currently a second year Society of Urologic Oncology Clinical Fellow at the University of Washington in Seattle, Washington. She is a graduate of the University of California, San Francisco School of Medicine, and completed her urology residency at the University of North Carolina, Chapel Hill.  During her fellowship research year, she was supported by the SUO and Urology Care Foundation Research Scholars grant to conduct health-services research with the goal of fusing surgical palliative care and urologic oncology in practice and research. 

 

Matthew Hudnall, MD, MPH
Northwestern Feinberg School of Medicine

Dr. Matthew Hudnall is a 5th year urology resident at Northwestern University intending to combine clinical practice with health outcomes research and quality improvement. He received his MD from University of California, San Francisco and completed a Master of Public Health in Health Policy and Management, where he examined the use of patient reported outcomes measure across various medical disciplines. His previous research has included clinical outcomes of patients undergoing surgery for stone disease, prostate cancer, and infertility. He has also completed the Chief Resident in Quality and Patient Safety program through the Veteran Health Affairs National Center for Patient Safety.

 

Samuel J. Ivan, MD
Atrium Health, Carolinas Medical Center

Dr. Sam Ivan is a third year resident at Carolinas Medical Center in Charlotte, NC. He has performed quality research related to urologic enhanced recovery after surgery protocols. His professional interests include reconstructive urology, teaching, and missions. Outside of work, he enjoys outdoor activities and national parks.

Jin Kyu (Justin) Kim, MD
University of Toronto

Jin Kyu (Justin) Kim is a third year urology resident at University of Toronto in Toronto, Canada. He has been working closely with the pediatric urology team at the Hospital for Sick Children (SickKids) since his undergraduate medical training and throughout residency. Current research interests include pediatric urology, pediatric kidney transplantation, artificial intelligence, and machine learning.

 

Suzanne Lange, MD
University of Utah

Dr. Suzanne Lange is completing her residency training at the University of Utah. She received her undergraduate degree in Chemistry in 2007 from Rose-Hulman Institute of Technology, with a double major in Biochemistry and Molecular Biology. She then worked in research and development for the consumer hair products division of Proctor & Gamble in Cincinnati, OH. She graduated from Indiana University School of Medicine in 2017. She will begin her urologic oncology fellowship at the University of Texas MD Anderson Cancer Center this summer. 

Farnoosh Nik-Ahd, MD
University of California, San Francisco

 

Farnoosh Nik-Ahd, MD is a third year Urology resident at UCSF. She has various research focuses, including frailty and surgical outcomes, transgender healthcare outcomes, and disparities affecting women in urology. She studied Women’s Studies and Neuroscience at UCLA, and attended UCLA for medical school as well. She hopes to ultimately pursue a career in academic medicine in order to continue her research and help mentor the next generation of urologists, particularly women entering the field. In her free time, she enjoys traveling, painting, and spending time with family. 

Niki Parikh, MD, MBA, MSBA
Mayo Clinic Urology, Rochester, MN

Dr. Niki Parikh is from Lubbock, Texas. She completed her undergraduate at Texas Tech University and received her MBA and MSBA in Health Organization Management from the Rawls College of Business Administration. She obtained her MD degree from Texas Tech University Health Sciences Center. She is currently a third-year urology resident at Mayo Clinic- Rochester and wishes to pursue a fellowship in andrology. Her interests include quality improvement utilizing the Six Sigma methodology, improving access to health care for all, reducing gender disparities, and advancing the field of andrology and infertility.

Minh Pham, MD
Northwestern University

 

Minh Pham earned his undergraduate degree at Duke University and his medical degree at University of North Carolina. He is currently finishing his residency at Northwestern University in Chicago, IL.

 

Dima Raskolnikov, MD
University of Washington

Dr. Raskolnikov is currently a Endourology & Minimally Invasive Surgery Fellow. Since participating in the 2017 AUA QI Summit on Imaging Stewardship, Dr. Raskolnikov has led efforts to reduce unnecessary radiation from imaging used to evaluate patients with suspected kidney stones. The resulting STONE Pathway for ED patients with renal colic is available as a Guide on AUA E-QIPS. In September 2022, he will join Montefiore/Albert Einstein as an Assistant Professor of Urology specializing in endourology and minimally invasive surgery.

Desiree E. Sanchez, MD
University of California, Los Angeles

Dr. Desiree Sanchez was born and raised in Delano, California and graduated from the University of California, Los Angeles with a degree in Psychobiology. She then worked in a neuropathology translational medicine laboratory before attending medical school at the University of Washington, Seattle. During medical school, she spent two years doing research in vascular surgery and developed the very first vascular surgery research database at UWSOM. Her clinical and research interests center on healthcare delivery to the underserved, which will be the focus of her research year work with Dr. Stanley Frencher at the Martin Luther King Hospital at UCLA. She is still deciding which type of fellowship she would like to pursue after residency.

Rishi Sekar, MD
University of Washington

 

 

Dr. Sekar is a Chief Resident at the University of Washington and incoming SUO Urologic Oncology Fellow and National Clinician Scholar at the University of Michigan. He is interested in leveraging health policy, health care delivery model innovation, and patient reported outcomes to improve care for patients with urologic cancers. 

David Tuke, MD
University of Texas Health Science Center at Houston

Dr. David Tuke attended Jefferson Medical College in Philadelphia, PA and was granted a full scholarship through the military. Upon graduation in 2014, he completed an intern year in General Surgery at University of Pennsylvania and went on to fulfill his commitment to the military. David spent four years as a Flight Surgeon in the Air Force Special Operations Command and was stationed in both New Mexico and the United Kingdom. He separated from the military in 2019 when he started residency at UTH. David has focused his energy on Quality Improvement projects to better delivery of care.

Fernandino Louis Vilson, MD
Stanford University School of Medicine

Fernandino L. Vilson, MD (Dino) is a 5th year urology resident at Stanford University school of Medicine and MBA candidate at UC Davis Graduate School of Management with a focus in leadership and innovation. During residency, Dino has been involved in quality improvement and patient safety projects which have led to successful interventions, improved education, and potential new product developments. He is currently applying to GURS fellowships with aspirations of becoming a fellowship director in the future. Outside of medicine, Dino enjoys playing and coaching youth basketball, mentoring URiM’s in urology, and spending time with his family.

 

Download the QI Summit Agenda


Virtual Sessions

Building a Primary Palliative Care Model for Urology

Saturday, May 15, 2021

This webinar focused on aspects of palliative care that benefit patients, the urologist’s role and their collaboration with palliative care clinicians, including:

The current state of palliative care:

  • Evidence for subspecialty-based primary palliative care
  • Aspects of palliative care that most benefit patients
  • Patient perspective – how doctors can best support patients at the end of life
  • Delivery of palliative care services in Urology

When palliative care is needed:

  • Panel discussion on identifying the continuum of care, timing, and the extent to which palliative care clinicians should be involved, with an emphasis on oncology, stone disease, and female pelvic medicine and reconstructive surgery

Watch Webinar #1


Perspectives on Increasing the Use of Palliative Care in Advanced Urologic Diseases

May 22, 2021

This webinar covered evidence-based innovations in primary palliative care in urology and role-specific readiness for implementation. This webinar focused on three primary objectives:

  • To engage palliative care clinicians and others on practice site clinical innovations in primary palliative care in urology
  • To delineate the clinical roles of various clinicians in the implementation of primary palliative care
  • To understand the perspectives of urologists at various stages of training regarding preparation for the implementation of palliative care concepts in urologic practice

This second webinar was part of the AUA2021 Annual Meeting Kickoff Weekend.


Funding for this conference was made possible [in part] by grant R13 HS 27765-01 from the Agency for Healthcare Research and Quality (AHRQ). The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.


Previous Quality Improvement Summit Resources and Materials

2018 Quality Improvement Summit: Opioid Stewardship in Urology

2017 Quality Improvement Summit: Challenges and Opportunities for Stewardship of Urological Imaging

2016 Quality Improvement Summit: Shared Decision Making and Prostate Cancer Testing

2014 Quality Improvement Summit: Infection Complications of Transrectal Prostate Needle Biopsy

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