Jieun Cha1, Elaine McKevitt2, Jin-Si Pao3, Carol Dingee4, Amy Bazzarelli5, Rebecca Warburton6. 1. Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada; Providence Breast Centre, Mount Saint Joseph Hospital, 3080 Prince Edward Street, Vancouver, BC, V5T 3N4, Canada. Electronic address: jieun.r.c.cha@gmail.com. 2. Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada; Providence Breast Centre, Mount Saint Joseph Hospital, 3080 Prince Edward Street, Vancouver, BC, V5T 3N4, Canada. Electronic address: EMcKevitt@providencehealth.bc.ca. 3. Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada; Providence Breast Centre, Mount Saint Joseph Hospital, 3080 Prince Edward Street, Vancouver, BC, V5T 3N4, Canada. Electronic address: JPao@providencehealth.bc.ca. 4. Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada; Providence Breast Centre, Mount Saint Joseph Hospital, 3080 Prince Edward Street, Vancouver, BC, V5T 3N4, Canada. Electronic address: Ckdingee@telus.net. 5. Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada; Providence Breast Centre, Mount Saint Joseph Hospital, 3080 Prince Edward Street, Vancouver, BC, V5T 3N4, Canada. Electronic address: ABazzarelli@providencehealth.bc.ca. 6. Faculty of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada; Providence Breast Centre, Mount Saint Joseph Hospital, 3080 Prince Edward Street, Vancouver, BC, V5T 3N4, Canada. Electronic address: RWarburton@providencehealth.bc.ca.
Abstract
INTRODUCTION: Timely access to breast cancer surgery is imperative for patient outcome. Building upon our previous model, 5 breast surgeons centralized all breast surgical referrals using principles of centralized intake and nurse navigator triage. The goal of this study was to investigate whether centralization can further improve access to surgery. METHODS: This study was designed as a before-after series, comparing wait times for breast cancer surgery prior to centralization and after. Primary outcome was wait time from diagnosis to surgery, and secondary outcomes included median wait time, days required for 90% case completion, number of available operating days, and number of patients who underwent breast reconstruction and neoadjuvant therapy. RESULTS: Overall, centralization of breast cancer surgical referrals reduced wait time from 47 to 41 days. The median wait time and time required for 90% of case completion was reduced, despite a 7% reduction in operating room availability. Fewer patients underwent neoadjuvant therapy and more patients underwent breast reconstruction following centralization. CONCLUSION: Centralization of surgical referrals for breast cancer patients improved access to surgery.
INTRODUCTION: Timely access to breast cancer surgery is imperative for patient outcome. Building upon our previous model, 5 breast surgeons centralized all breast surgical referrals using principles of centralized intake and nurse navigator triage. The goal of this study was to investigate whether centralization can further improve access to surgery. METHODS: This study was designed as a before-after series, comparing wait times for breast cancer surgery prior to centralization and after. Primary outcome was wait time from diagnosis to surgery, and secondary outcomes included median wait time, days required for 90% case completion, number of available operating days, and number of patients who underwent breast reconstruction and neoadjuvant therapy. RESULTS: Overall, centralization of breast cancer surgical referrals reduced wait time from 47 to 41 days. The median wait time and time required for 90% of case completion was reduced, despite a 7% reduction in operating room availability. Fewer patients underwent neoadjuvant therapy and more patients underwent breast reconstruction following centralization. CONCLUSION: Centralization of surgical referrals for breast cancerpatients improved access to surgery.
Authors: Merijn E de Swart; Mathilde C M Kouwenhoven; Tessa Hellingman; Babette I Kuiper; Cathelijne Gorter de Vries; Machteld Leembruggen-Vellinga; Niels K Maliepaard; Ernest J Wouda; Bastiaan Moraal; David P Noske; Tjeerd J Postma; Esther Sanchez Aliaga; Bernard M J Uitdehaag; William P Vandertop; Barbara M Zonderhuis; Geert Kazemier; Philip C de Witt Hamer; Maaike Schuur Journal: Neurooncol Pract Date: 2021-07-06
Authors: Lina Cadili; Kristin DeGirolamo; Elaine McKevitt; Carl J Brown; Christopher Prabhakar; Jin-Si Pao; Carol Dingee; Amy Bazzarelli; Rebecca Warburton Journal: Breast Cancer Res Treat Date: 2020-11-04 Impact factor: 4.624