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Directory of Authors from the Journal and their last article.

Mary B AjadiView Articles

Volume 15, Number 3Review Articles

Prostate-Specific Antigen: Any Successor in Sight?

Diagnostic Review

Aniebietabasi S ObortMary B AjadiOluyemi Akinloye

Prostate cancer (PCa) is the most frequently diagnosed malignancy and the second leading cause of cancer death in men in the United States and other parts of the world. The lifetime risk of being diagnosed with PCa is approximately 16%. At present, the only widely accepted screening tools for PCa are prostate-specific antigen (PSA) and digital rectal examination. PSA is known to be prostate specific, but not PCa specific, and hence lacks the sensitivity to detect a large number of tumors, especially during the early stages. The PSA level is also known to be affected by many factors, such as medication, inflammation (benign prostatic hyperplasia and prostatitis), and urologic manipulation; hence, the controversy regarding the appropriate level of serum PSA that should trigger a biopsy or have clinical relevance to prostate metastases. Attempts to determine the level of prostate cells in peripheral blood by reverse transcriptase polymerase chain reaction did not significantly improve cancer diagnosis or predict postoperative failure. Therefore, the search continues for a novel biomarker or a panel of markers as well as other possible interventions to improve the use of PSA. This article reviews several possibilities. [Rev Urol. 2013;15(3):97-107 doi 10.3909/riu0567] © 2013 MedReviews®, LLC

Prostate-specific antigenProstate carcinomaProstate diagnostic or screening test

Mary M SmithView Articles

Volume 22, Number 2Review Articles

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

Original Research

Gary M KirshStephen F KappaChris McClainKrista WallacePaul CinquinaDon LawsonMary M SmithEarl WalzBrooke Edwards

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 effectivenessCall centerTelehealthOrganizational efficiency