A facility should be structured to offer preoperative evaluation including second opinions when required. B. Treatment guidelines should be available, consistent with specific manufacturers recommendations and the state of the art as determined by experience and medical literature. The staff should meet standard requirements for training and certification. A Quality Assurance program must be in place and function regularly. Postoperative care must be available and meet urologic standards for surgical procedures.
Data collection is necessary for outcome analysis.
C. High quality, cost effective stone treatment includes consideration of all methods including observation, medical management, open surgery, percutaneous and endoscopic technique, and alternative methods of lithotripsy. There should be reasonable availability of adjunctive and alternative techniques. Knowledge of the advantages and disadvantages of all alternatives is necessary for patient selection, safety and efficacy. D. Cognitive skills required for the successful management of stone disease are considerable, and must be coupled with the technical skills necessary for lithotripter treatment. Patient safety and effective outcome are the ultimate goals.