Roadmap for the transition to robotic radial cystectomy for patients with bladder cancer in a tertiary urology unit: planning for change.

Abstract

Background: Radical cystectomy has the potential to be a curative strategy for patients with aggressive bladder cancer. Emerging evidence over the last 20 years has shown that minimally invasive surgical approaches using robotics in performing this highly complex and morbid operation can achieve the same oncological outcomes while reducing complications for the patient.

Objective: This paper aims to present a managerial and leadership roadmap for change to robotic cystectomy for patients with advanced bladder cancer to achieve improved patient outcomes while embracing technological developments in the delivery of cancer care.

Methods: Using the Irish Health Service Executive guide for change, we propose and detail a three-stage plan (define, design and deliver) to guide the organisation from the concept of the transition to performing the first operative case.

Results: A walkthrough from identifying a vision for change for robotic cystectomy to designing a step-by-step process is discussed. By providing a template for success, this approach can be applied to any health jurisdiction worldwide and can be adapted as needed.

Conclusion: Although challenging, major change within the healthcare setting through a structured approach provides a valuable opportunity for a department to grow, develop and become a champion of patient care.