INTRODUCTION: Breast cancer is common among Danish women with more than 4,100 new cases annually. In 2008 the concept of fast-track surgery was introduced at the Department of Breast Surgery at Rigshospitalet, Copenhagen. The aim of this study is to describe the new clinical pathway for breast cancer patients after implementation of a fast-track surgery programme. MATERIAL AND METHODS: A clinical pathway of all involved disciplines was developed including anaesthetic, analgesics, nausea and vomiting, drain and wound management, discharge assessment and psychosocial support. RESULTS: The overall mean length of stay (LOS) decreased from 3.6 days before introduction of fast-track surgery to 1.2 days after its implementation. The largest decrease was observed among patients undergoing mastectomy, where LOS was reduced from 5.0 to 1.6 days. The number of beds at the department was reduced by about 30% and a nurse-led clinic was established which enabled nurses to take charge of wound management, seromas, temporary breast prostheses and psychosocial and rehabilitation aspects in the outpatient clinic. Additionally, the previously available telephone counselling service was intensified to provide immediate advice and support. CONCLUSION: The results confirm that a short stay can be successfully carried out for breast cancer patients. Implementing the fast-track programme involved the introduction of a clear clinical pathway for the patients and more effective daily routines. Patients felt safe and confident after early discharge. FUNDING: not relevant. TRIAL REGISTRATION: not relevant.
INTRODUCTION:Breast cancer is common among Danish women with more than 4,100 new cases annually. In 2008 the concept of fast-track surgery was introduced at the Department of Breast Surgery at Rigshospitalet, Copenhagen. The aim of this study is to describe the new clinical pathway for breast cancerpatients after implementation of a fast-track surgery programme. MATERIAL AND METHODS: A clinical pathway of all involved disciplines was developed including anaesthetic, analgesics, nausea and vomiting, drain and wound management, discharge assessment and psychosocial support. RESULTS: The overall mean length of stay (LOS) decreased from 3.6 days before introduction of fast-track surgery to 1.2 days after its implementation. The largest decrease was observed among patients undergoing mastectomy, where LOS was reduced from 5.0 to 1.6 days. The number of beds at the department was reduced by about 30% and a nurse-led clinic was established which enabled nurses to take charge of wound management, seromas, temporary breast prostheses and psychosocial and rehabilitation aspects in the outpatient clinic. Additionally, the previously available telephone counselling service was intensified to provide immediate advice and support. CONCLUSION: The results confirm that a short stay can be successfully carried out for breast cancerpatients. Implementing the fast-track programme involved the introduction of a clear clinical pathway for the patients and more effective daily routines. Patients felt safe and confident after early discharge. FUNDING: not relevant. TRIAL REGISTRATION: not relevant.
Authors: Deirdre P Cronin-Fenton; Uffe Heide-Jørgensen; Thomas P Ahern; Timothy L Lash; Peer M Christiansen; Bent Ejlertsen; Per Sjøgren; Henrik Kehlet; Henrik T Sørensen Journal: Cancer Date: 2015-07-24 Impact factor: 6.860
Authors: Ingrid Annette Zøylner; Kirsten Lomborg; Peer Michael Christiansen; Pia Kirkegaard Journal: Health Expect Date: 2019-01-12 Impact factor: 3.377