Complications and high readmission rates are a persistent challenge following radical cystectomy for the treatment of bladder cancer. The complex, intrabdominal operation, which includes replacement of the bladder or creation of a stoma, and often includes removal of reproductive organs as well, is associated with a high rate of morbidity. Patients undergoing the procedure often have additional risk factors for venous thromboembolism (VTE), such as pre-operative chemotherapy, older age and a history of smoking, and VTE is estimated to occur in 5.5 to 8.5 percent of patients and cost more than $10,000 per event. In a comprehensive effort to reduce risk of VTE, reduce length of stay and improve other measures of quality of care, Brigham and Women’s Hospital urologists have implemented a perioperative VTE prophylaxis program and analyzed its results, reporting key quality of care improvements. In addition, in collaboration with nurses, anesthesiologists, pharmacists and other members of patients’ care teams, clinicians in the Division of Urology are exploring innovative initiatives to continue to make strides in improving patient care.
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