Developing a continence care centre using an urban/academic model of continence care.

BACKGROUND: This paper describes the process of adopting the Canadian Continence Foundation's urban/academic model of continence care in the development of British Columbia's Bladder Care Centre, using a process that can serve as a model for other jurisdictions across Canada and internationally. METHOD: A multidisciplinary Working Group assessed the existing system, analyzed local and national statistics, and reviewed the literature on urinary incontinence and models of health care. Following approval from university and hospital authorities, continence services were reorganized including changing infrastructure, altering the location of multidisciplinary services and restructuring of funding and resource allocation. The process was overseen by a steering committee. RESULTS: The plan for the Bladder Care Centre involves diagnostic services and tertiary care coordinated with translational research in voiding dysfunction. Affiliations to university programs and teaching hospitals enable comprehensive interdisciplinary health professional education, training and research, which are distinguishing features of the Canadian Continence Foundation urban academic model. CONCLUSION: From the planning perspective, the Canadian Continence Foundation's urban/academic model of continence care was feasible to implement but required significant changes to hospital budgets and infrastructure related to the existing health care system. Program evaluation markers built into the plan will allow future reporting on whether actual improvements can be achieved, and the degree to which the plan can deliver cost savings.