After years of planning and 2 postponed dates due to COVID-19, the AUA convened the in-person portion of the 2022 Quality Improvement Summit, “Laying the Foundation for Primary Palliative Care in Urology” (available at https://www.auanet.org/guidelines-and-quality/quality-and-measurement/patient-safety-and-quality-of-care/quality-improvement-summit), at AUA2022. Urologists have played a major role in the development of the field, with Balfour Mount, a urologic oncologist, credited as the father of modern palliative care in North America. Palliative care improves the quality of life of patients and families who are facing challenges associated with serious illness, whether physical, psychological, social, or spiritual. However, there are not enough palliative care specialists to fulfill the palliative care needs of these patients. A solution to this shortage is primary palliative care: palliative care that is delivered by non-palliative care specialists, like urologists, often but not always in collaboration with specialty palliative care providers.

The Quality Improvement Summit, directed by Dr John Gore and Dr Jonathan Bergman, focused on improving patient-centeredness and care quality by identifying ways to integrate primary palliative care into urology. The summit comprised 2 webinars (available for review on the AUA website) and an in-person meeting. Presenters in the first webinar, “Building a Primary Palliative Care Model for Urology” (available at https://auau.auanet.org/content/building-primary-palliative-care-model-urology-webcast-2021), discussed opportunities for palliative care within urological practice and urologists’ roles in providing that care, including how and when to collaborate with palliative care clinicians. Faculty in the second webinar, “Perspectives on Increasing the Use of Palliative Care in Advanced Urologic Disease” (available at https://vimeo.com/auaedu/review/554816041/7111b07dfc), covered evidence-based innovations in primary palliative care in urology and role-specific readiness for implementation.

Building on the information and ideas from these webinars, participants in the highly interactive in-person conference collectively identified best practices and strategies for developing and implementing a primary palliative care intervention for urology. Panelists included urologists from various practice settings and experience levels, as well as palliative care physicians and a social worker. A cadre of trainees who received travel stipends to attend the summit engaged in rich discussion of how to operationalize a primary palliative care model in urology, the clinical innovations and interventions needed, and outcomes and metrics that should be tracked. Some of the key strategies articulated by participants included inviting palliative care providers to speak at urology grand rounds, requiring trainees to meet standardized palliative care competencies at each level of training and complete a palliative care rotation or shadow experience, and implementing a multidisciplinary tumor board with the involvement of palliative care clinicians. Metrics discussed included rates of screening and re-screening for palliative care needs, rate of referral to palliative care consult, patient decision regret of treatment choice, and quality of life, among many others. A key takeaway from the discussions was the unique challenges of providing primary palliative care for urologists in private practice.

Additional detailed proceedings and products from the summit will be posted on the AUA website in the near future. I look forward to future discussion and collaboration to advance the primary palliative care model in the field of urology!