UNC Urology is pleased to share that Drs. Matthew Nielsen and Dave Friedlander were featured in a recent episode of the American Urological Association’s podcast, AUA Inside Tract. The episode, titled “Diagnostic Excellence in Urology Care,” dives deep into the emerging concept of diagnostic excellence, exploring its critical role in delivering high-quality, effective, and patient-centered care.
Dr. Matthew Nielsen, Chair of the AUA’s Science and Quality Council and Chair of UNC Urology, joined Dr. David Friedlander, a fellow UNC Urology faculty member and member of the AUA’s Quality Improvement and Patient Safety (QIPS) Committee, to discuss the challenges and opportunities in the diagnostic process. Together, they examined the transformative potential of diagnostic excellence in improving outcomes, reducing errors, and enhancing the overall value of care.
We invite you to explore this insightful conversation and learn how UNC Urology faculty are helping to shape the future of urologic care.
What is Diagnostic Excellence?
In the podcast, Dr. Nielsen described diagnostic excellence as “an optimal process to attain an accurate and precise explanation about a patient’s condition.” This process extends beyond reducing diagnostic errors—it emphasizes timeliness, cost-effectiveness, convenience, and patient-centered communication. By leveraging this framework, urologists can deliver better outcomes while addressing systemic challenges in healthcare.
Dr. Friedlander highlighted the tangible impact of diagnostic excellence, citing that diagnostic errors account for 6 to 17% of hospital adverse events and up to 10% of patient deaths annually. Beyond patient harm, these errors contribute to significant healthcare waste—estimated at $900 billion annually in the U.S. The podcast emphasized how improving diagnostic processes not only benefits patients but also drives efficiency in care delivery.
UNC’s Leadership in Advancing Urologic Care
Both Dr. Nielsen and Dr. Friedlander brought their unique clinical and academic perspectives to the discussion. Dr. Nielsen, a urologic oncologist, spoke about the critical importance of diagnostic excellence in managing complex conditions like bladder and prostate cancers. Meanwhile, Dr. Friedlander, whose practice focuses on endourology, shared examples from stone disease management that exemplify the principles of safe, timely, effective, efficient, equitable, and patient-centered care (the STEEP framework).
The duo also discussed the AUA’s quality agenda for urology, which prioritizes diagnostic excellence as a cornerstone of advancing practice. With grants from the Gordon and Betty Moore Foundation and the John Hartford Foundation, the AUA is actively developing educational resources, such as algorithms and infographics, to support providers in achieving excellence in diagnostics.
A Shared Vision for High-Value, Patient-Centered Care
In reflecting on the podcast, Dr. Friedlander noted, “Diagnostic excellence is about optimizing patient experience and outcomes, but it also has a practical component. By improving the diagnostic process, we’re contributing to the delivery of value-based care that balances quality and cost.”
Dr. Nielsen echoed this sentiment, emphasizing the collaborative nature of diagnostic excellence: “In urology, we work alongside a range of specialists, addressing diagnostic needs that span from cancers to kidney stones. The breadth of our practice demands an ongoing commitment to refining the diagnostic process.”