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Improvement Opportunities Identified from Breast Programs in the United States

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Rhondalyn (Rhonda) Bomkamp is an accomplished Director/Nurse Leader with a proven track record of effectively managing complex projects and health system performance improvement initiatives. As a registered nurse, she has experience in Quality and Patient Safety and Project Management/Development in the oncology, cardiac and intensive care arenas. She has strong clinical knowledge and management experience with the ability to recognize opportunities for improvement, coordinate the work of many areas and develop collaborative relationships with diverse groups to facilitate the implementation of change

Kimberly (Kim) Byrwa-Neff is a registered nurse with a background in both clinical nursing as well as in evidence generation in industry. Her clinical expertise lies in cardiology as well as oncology, specifically breast cancer. As a nurse, black belt in process excellence, daughter of a breast cancer patient, and survivor of breast cancer herself, she brings the full patient experience to her work to improve care for breast cancer patients. Kimberly has authored numerous papers and presented improvement in clinical outcomes as a result of working with breast teams across the country.

Background

In partnership with the National Consortium of Breast Centers, Leica Biosystems’ Process & Solution Optimization team worked with several hospitals with the goal to improve the quality and efficiencies of their breast programs. Through this work, the team identified common barriers and improvement opportunities.

Method

Leica Biosystems’ team of clinical and process experts spent several days at each breast center. Prior to the visit, breast program data and minutes from the leadership committee meeting were reviewed. Breast Care Team sponsors were identified, and teleconferences were conducted to gather information on the areas of concern. During the site visit, the team attended a breast conference, a breast program leadership committee (BPLC) meeting, and a cancer committee meeting. Process observations occurred from the time the patient entered the imaging suite, until the time their diagnosis and treatment plan were ready for delivery in the imaging center and pathology lab. Meetings were conducted with support staff including tumor registrars, nurse navigators, administrators and the breast surgeon.

Results

Four common barriers and improvement opportunities were identified:

Barrier#1: Lack of timely data to drive breast care coordination and prioritization
Opportunity: 1.) Education on the input of data and use of the NQMBC database to deliver reports on performance and peer comparison data.
2.) Recommendation to share data at the BPLC level to drive quality improvement initiatives.
Barrier #2: Inefficiencies in patient scheduling and prior authorizations
Opportunity: Conduct a cross-departmental process flow mapping session to identify where inefficiencies are occurring and brainstorm solutions. (i.e.: a standardized work
process, setting priorities, and a look at centralized vs. decentralized scheduling.)
Barrier #3: Lack of common goal deployment across departments
Opportunity: Initiate interdepartmental communications and emphasize the importance of interdepartmental task interdependence.
Barrier#4: Outmigration
Opportunity: 1.) Complete a community image assessment to drive program promotion and brand awareness.
2.) Track patient reasons for outmigration and address opportunities
3.) Take advantage of benchmark data and all accreditations in marketing materials

 

Conclusion

Our hypothesis is that the combination of clinical expertise paired with industry expertise in process improvement can create and analyze data to drive deeper conversations around provision of high quality patient care. Inclusion of lean principles and national benchmarks for quality can result in improved efficiencies for the breast center ideally leading to better patient outcomes.

Disclaimer

This reference document is presented as a service to health care professionals by Leica Biosystems and has been compiled from available literature. Although every effort has been made to report faithfully the information, Leica Biosystems cannot be held responsible for the correctness. This document is not intended to be, and should not be construed as medical advice. For any use, the product information guides, inserts and operation manuals of the various drugs and devices should be consulted. Leica Biosystems and the editors disclaim any liability arising directly or indirectly from the use of drugs, devices, techniques or procedures described in this reference document.

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