Editorial Board About Us

Gary M Kirsh

All articles from this author are listed below.

Volume 17, Number 3 LUGPA News

From the President’s Desk: LUPGA Announces Its First CEO, Celeste Kirschner

[Rev Urol. 2015;17(3):178 doi: 10.3909/riu1703LUGPA] © 2015 MedReviews®, LLC

Volume 17, Number 2 LUGPA News

From the President’s Desk: 2015 Updates and a Look Forward

[Rev Urol. 2015;17(2):84-85 doi: 10.3909/riu0678] © 2015 MedReviews®, LLC

Volume 18, Number 1 LUGPA News

The State of Independent Urology

[Rev Urol. 2016;18(1):33-34 doi: 10.3909/riu0708] © 2016 MedReviews®, LLC

Volume 18, Number 2 LUGPA News

Are Independent Urology Practices Embracing Business and Clinical Integration to Prepare for the Coming Era of Value-based Payment?

[Rev Urol. 2016;18(2):103-105 doi: 10.3909/riu0719] © 2016 MedReviews®, LLC

Volume 18, Number 4 Practice Profile

Advanced Prostate Cancer in Large Group Practices

David M. Albala Gary M Kirsh Neal D Shore

[Rev Urol. 2016;18(4):226-230 doi:10.3909/riu0737] © 2016 MedReviews®, LLC

Volume 18, Number 4 LUGPA News

2014-2016: How Far Has LUGPA Come?

[Rev Urol. 2016;18(4):221-224 doi: 10.3909/riu0735] © 2016 MedReviews®, LLC

Volume 21, Number 2 Review Articles

Preserving Independent Urology: LUGPA’s First Decade

Review

Robert D Asinof Earl L Walz David C Chaikin Evan R Goldfischer Richard G Harris Jonathan Henderson Gary M Kirsh Deepak A Kapoor Neal D Shore

[Rev Urol. 2019;21(2/3):102–108] © 2019 MedReviews®, LLC

Volume 21, Number 2 Original Research

The Effect of Local Antibiogram–based Augmented Antibiotic Prophylaxis on Infection-related Complications Following Prostate Biopsy

Original Research

Jeffrey A Scott Edward M Schaeffer Raoul S Concepcion Gary M Kirsh Deepak A Kapoor Neal D Shore

Given the number of prostate biopsies performed annually in the United States and associated infectious events as a result, we sought to determine if implementation of a standardized biopsy protocol utilizing antibiotic prophylaxis based on locally derived antibiograms would result in a decrease, relative to a contemporary control population, in the incidence of infection-related complications among community-based practices. A total of nine member groups of LUGPA participated in both a retrospective review and a prospective study of infection-related complications following prostate biopsy. Historic infectious complications, defined as chills/rigor, temperature higher than 101 °F, or documented positive blood or urine cultures, were self-reported by a retrospective review of patients undergoing prostate biopsy under the practice’s current protocol in the year prior to the study. The prospective phase of the study required each group to develop a locally derived augmented prophylaxis regimen (>2 antibiotics) based on local antibiograms. After implementation, the practices enrolled patients undergoing prostate biopsy over an 8-week period. Monitoring for infection-related complication took place over the ensuing 3 weeks post-biopsy. Seven hundred fifty-nine patients over nine practices were enrolled into the study utilizing the augmented locally determined prophylaxis protocol. There was a 53% reduction in the incidence of infection-related complication, relative to the historical rate. By developing a standardized biopsy protocol with specific emphasis on incorporating an augmented antibiotic prophylactic regimen based upon local antibiograms, we were able to demonstrate in a prospective trial across nine geographically distinct community practices a significant reduction in the incidence of infection-related complications. [Rev Urol. 2019;21(2/3):93–101] © 2019 MedReviews®, LLC

Antibiotic prophylaxis Prostate Biopsy Drug-resistant bacteria

Volume 22, Number 2 Review Articles

Implementation of a Centralized, Cost-effective Call Center in a Large Urology Community Practice

Original Research

Chris McClain Brooke Edwards Earl Walz Mary M Smith Don Lawson Paul Cinquina Krista Wallace Stephen F Kappa Gary M Kirsh

Call centers provide front-line care and service to patients. This study compared call-answering efficiency and costs between the implementation of an internal, centralized call center (January to July 2019) and previously outsourced call-center services (January to July 2018) for a large urology community practice. Retrospective review of call metrics and cost data was performed. Internal call-center leadership, training, and culture was examined through survey of staff and management. A total of 299,028 calls with an average of 5751 calls per week were answered during the study periods. The Average Speed of Answer (ASA) was 1:42 (min:s) for the outsourced call center and 0:14 for the internal call center (P < 0.001), with 70% of outsourced calls answered under 2 minutes compared with 99% of calls for the internal call center (P < 0.001). The Average Handle Time (AHT) for each outsourced call was 5:32 versus 3:41 for the internal call center (P < 0.001). The total operating expenses were 7.7% lower for the internal call center. Surveys revealed the importance of engaged leadership and staff training with feedback, simplified work algorithms, and expanded clinical roles. We found that internal, centralized call centers may provide a call-answering solution with greater efficiency and lower total operating expense versus an outsourced call center for large surgical practices. A culture that emphasizes continuous improvement and empowers call-center staff with expanded clinical roles may ultimately enhance patient communication and service. [Rev Urol. 2020;22(2):67–74] © 2020 MedReviews®, LLC

Cost effectiveness Call center Telehealth Organizational efficiency