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AND OBJECTIVES: The American Urological Association (AUA) published guidelines for renal mass and localized renal cancer in 2017. The Michigan Urological Surgery Improvement Collaborative: Kidney mass: Identifying and Defining Necessary Evaluation and therapY (MUSIC-KIDNEY) program analyzes the patterns of care across the state of Michigan for patients diagnosed with localized renal masses ⩽ 7cm in size (RM ⩽ 7cm). We report initial adherence to these guidelines within this regional quality improvement collaborative for kidney cancer. METHODS: Proposed and approved in 2015, MUSIC-KIDNEY commenced after beta testing with data collection in September 2017 at 8 diverse MUSIC practices. Data abstractors recorded clinical, radiographic, pathologic, and short-term follow-up data into the registry for patients with a newly-diagnosed RM ⩽ 7cm. RESULTS: During the initial 12 months of data entry, 8 pilot practices (39 physicians) evaluated 581 patients with newly diagnosed RM ⩽ 7cm. AUA guidelines recommend newly diagnosed RM ⩽ 7cm patients receive a complete metabolic profile (CMP), complete blood count (CBC), urinalysis (UA), chest x-ray or CT thorax (chest imaging), and cross-sectional abdominal imaging (CT or MRI). Of 581 MUSIC-KIDNEY patients, CBC was documented in 72% (n=420), CMP in 69% (n=422), UA in 73% (n=331), chest imaging in 35% (n=203), and CT or MRI in 91% (n=526). Only 97 patients (17%) received all recommended testing: CMP, CBC, UA, CXR or CT thorax, and CT or MRI. AUA guideline adherence varied at a practice level from 0-63% (Figure). CONCLUSIONS: In the initial assessment of clinical evaluation patterns for patients with localized RM ⩽ 7cm, less than a fifth of patients received all elements of preliminary testing recommended by the AUA guidelines. The primary reason for failure to complete all recommended testing was absence of chest imaging. There was significant practice-level variation for overall guideline adherence and for individual tests, particularly chest imaging. Figure. No caption available. Source of Funding: Funding from Blue Cross Blue Shield of Michigan

PD58-08 A STATEWIDE QUALITY IMPROVEMENT COLLABORATIVE’S ADHERENCE TO 2017 AUA GUIDELINES REGARDING INITIAL EVALUATION OF RENAL MASSES