One of MUSIC’s primary aims is to improve the short term recovery outcomes of radical prostatectomy for men in Michigan. In order to improve, MUSIC recognized the need for identifying a peri-operative pathways that could be easily and consistently measured. As a result, MUSIC created a peri-operative assessment called Notable Outcomes and Trackable Events after Surgery (NOTES), which includes actionable data points that collectively reflect practice patterns and resource utilization, technical complications, and coordination of care. MUSIC-NOTES was implemented in early 2014, and includes the following eight criteria that define an uncomplicated, early recovery pathway: 1) no rectal injury, 2) estimated blood loss (EBL) < 400mL (90th percentile), 3) length of stay (LOS) < 2 days, 4) drain placement < 2 days, 5) catheter placement < 16 days, 6) no indwelling catheter replacement, 7) no 30-day readmission, 8) no 30-day mortality. Events that occur outside any of the aforementioned criteria are considered a deviation from the uncomplicated recovery pathway. Feedback around this uncomplicated recovery pathway is delivered to providers through an individualized, automatically generated, one page report that presents comparative NOTES data for a surgeon, their practice, and the MUSIC collaborative. The NOTES report clearly and succinctly features an overall summary of the percentage of cases experiencing at least one deviation, a table with a detailed breakdown around cases experiencing each NOTE deviation, and graphs with trend analyses over time.
If you wish to learn more about MUSIC-NOTES, please watch the following short video describing the initiative.