Notable Outcomes and Trackable Events after Surgery (NOTES)

Improving recovery after a Radical Prostatectomy


One of MUSIC’s primary aims is to improve the short term recovery outcomes of radical prostatectomy for men in Michigan. MUSIC recognized the need for identifying a perioperative pathway (delivery of patient care before, during, and after surgery) that could be easily measured.  In 2014, 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 (see Figure 1).  Events that occur outside any of the criteria are considered a deviation from the uncomplicated recovery pathway.

What is MUSIC NOTES working toward?

By collecting reliable clinical data, providing data-driven feedback to providers about their patient outcomes, and developing a catalogue of quality improvement guidelines that can be implemented at practices across the state, NOTES aims to raise the quality of peri-operative care for men in Michigan, as well as reduce adverse events and their associated costs following radical prostatectomy.

MUSIC is particularly focused on reducing modifiable readmissions after radical prostatectomy.  To help with this, MUSIC developed a patient education ileus (severe constipation) pamphlet which explains the severity of an ileus and expectations before and after surgery.   These educational pamphlets are available in your MUSIC urologist’s office.  They can also be downloaded and printed below.

To watch a patient educational video on education and expectations after undergoing prostate surgery to aid in recovery, please click on the link below:

For a patient educational pamphlet on preventing an ileus following a radical prostatectomy, please click on the link below:

Download NOTES Pamphlet

Feedback around the uncomplicated recovery pathway is delivered to providers through an individualized, automatically generated, one page report—comparing 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 NOTES deviation, and graphs with trend analyses over time.

For an example of a NOTES physician report, please click on the link below:

Download NOTES Report

If you have further questions or concerns regarding MUSIC NOTES, please contact the MUSIC Coordinating Center at 855.456.2035 or