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The Uroguidance Program
What is the Uroguidance Program?
The Uroguidance program was developed with the goal of helping nursing facilities and their patients by bringing specialized urologic care directly to the residents within these facilities. Seven years of providing urologic care within nursing facilities along with an extensive multi-year review of both the urologic and geriatric literature has produced a systematic approach for optimizing urinary health designed specifically to address the unique needs of the nursing facility population.
Reducing Infections and Improving Health
The primary focus of the Uroguidance program targets the management and prevention of urinary tract infections. In addition to direct patient care, counseling of residents and their families, as well as education of the nursing and medical staff of the facility on the latest guidelines for urologic care are important aspects of this program. Data outcome analysis is another essential part of the program, monitoring a facility’s progress in areas including UTI rates, antibiotic days for UTI treatment, and the number of urinary infections caused by antibiotic resistant bacteria. Other important tracking data include hospital readmissions due to urologic causes as well as the number of residents who no longer need to be transported out for in-office urologic consultation.
FAQ
Who provides the urologic care to residents?
Answer: Specially trained NP/PA’s who have completed the extensive Uroguidance Training Program provide care to residents who have been identified as having urologic issues that need evaluation. These NP/PA’s are supported by local board-certified urologists who are available for questions.
Is there a charge to the facility for their services?
Answer: No. There is no charge to the facility for the Uroguidance program.
Are there any conflicts with billing by the primary care providers in the facility?
Answer: No. The Uroguidance providers bill under Medicare Part B, so there is no conflict with the primary care providers who are billing under Medicare Part A for skilled patients.
Which urologic problems do the Uroguidance program manage in the nursing facilities?
Answer: The primary focus of the Uroguidance program is the management and prevention of urinary tract infections. Foley catheter management is another important service, with our providers helping to devise strategies to safely remove catheters as quickly as possible. Our providers can also help to determine when continued urinary catheter use is justified and provide documentation of medical necessity, as well as provide guidance on minimizing catheter-related complications in these uncommon patients. The Uroguidance program also helps to manage other urologic problems such as poor bladder emptying, urinary incontinence, overactive bladder, and dysuria.
Can comprehensive general urologic care be provided at the facility?
Answer: No. Our providers try to manage as many urologic problems as they can at the facility to minimize the number of trips that residents need to make to outside urology offices. However, there are some more complex issues that cannot be managed at the nursing facility and these residents would need to see the urologist in the office.
Examples include problems such as kidney stones, bladder/kidney tumors, and prostate cancer. The resources for adequate management of these more complex urologic problems are just not available outside the urology office setting, but our providers can help to facilitate coordination of the appointments to see an in-office urologist if needed.
How is overall coordination of care provided to the residents?
Answer: The primary care providers at the facility remain the “quarterback” of every resident’s overall care. The role of the Uroguidance provider is to provide recommendations on urologic issues based on the latest urology guidelines. However, if there is ever a disagreement on patient care choices (an experience which has been very rare in our experience), the primary care provider always gets the final word, since they have a better view of that resident’s overall global health needs.