Access to surgery following centralization of breast cancer surgical consultations
Access to surgery following centralization of breast cancer surgical consultations
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DOI：
10.1016/j.amjsurg.2020.01.050
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发表时间：
2020-05-01
影响因子：
3
通讯作者：
Warburton, Rebecca
中科院分区：
文献类型：
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作者：
Cha, Jieun;McKevitt, Elaine;Warburton, Rebecca
引言：及时接受乳腺癌手术对患者的预后至关重要。在我们以前的模型的基础上，5名乳腺外科医生使用集中摄入和护士导航分诊的原则集中所有乳腺外科转诊。本研究的目的是调查集中是否可以进一步提高访问surgery.Methods：本研究被设计为一个前后系列，比较等待时间乳腺癌手术前集中和后。主要结果是从诊断到手术的等待时间，次要结果包括中位等待时间，90%的情况下完成所需的天数，可用的手术天数，以及接受乳房重建和新辅助治疗的患者人数。结果：总体而言，集中乳腺癌手术转诊减少等待时间从47天到41天。尽管手术室可用性减少了7%，但平均等待时间和90%病例完成所需的时间减少了。较少的患者接受新辅助治疗，更多的患者接受乳房再造后centralization.Conclusion：乳腺癌患者的手术转诊的集中化改善了手术的可及性。(C)2020爱思唯尔公司All rights reserved.
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. (C) 2020 Elsevier Inc. All rights reserved.