Multidisciplinary breast clinic: Impact on patient satisfaction, timeliness, and guideline concordant care.

Authors

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Caitlin Laurel Gomez

University of California, Los Angeles, Los Angeles, CA

Caitlin Laurel Gomez, Nicole Ann Dawson, Robyn Lynn Dvorak, Nova Foster, Anne Hoyt, Sara A. Hurvitz, Amy Kusske, Charles Y. Tseng, Susan Ann McCloskey

Organizations

University of California, Los Angeles, Los Angeles, CA, University of California, Los Angeles, Santa Monica, CA, UCLA's David Geffen School of Medicine, Los Angeles, CA

Research Funding

No funding sources reported

Background: After recent implementation of a multidisciplinary breast clinic (MDC) for newly diagnosed women at our institution, we sought to examine the impact of MDC on patient satisfaction, timeliness and guideline concordant care. Methods: Women with newly diagnosed breast cancer at our institution are referred to MDC where they are seen by a team of breast specialists for initial consultation. The MDC model is further facilitated by a patient navigator/coordinator who serves as a single point of contact across disciplines and through the continuum of care. We deployed patient satisfaction surveys querying helpfulness of the care coordinator and satisfaction with seeing breast cancer specialty physicians together in one visit. We further retrospectively analyzed timeliness of care and guideline concordant care since MDC implementation. Results: Patient satisfaction survey response rate was 42% (n=133).On a scale of 1 (very poor) – 5 (excellent), 93% of respondents rated helpfulness of care coordinator as excellent and seeing specialty physicians together in one visit as excellent. 99% of respondents rated these factors as either excellent (5) or good (4). Regarding timeliness, among 202 women with newly diagnosed, non-metastatic breast cancer seen in MDC between June 2012 and April 2014, mean time from neoadjuvant chemotherapy to surgery was 43.1 days (range 26-78 days), from surgery to adjuvant radiation was 39.2 days (range 22-79 days), from surgery to adjuvant chemotherapy was 40.6 days (range 19-89 days), and from adjuvant chemotherapy to radiation was 34.9 days (range 13-67 days). All timeliness metrics well exceeded established national standards of 60-90 days. Regarding guideline concordant care, 94% and 90% respectively received indicated radiation therapy and chemotherapy in accordance with National Comprehensive Cancer Network (NCCN) Guidelines. Those not receiving guideline concordant care either declined, were of advanced age, or had prohibitive co-morbidities. Conclusions: The MDC model, which emphasizes care coordination via a team approach and patient navigation, is associated with excellent patient satisfaction and timely, guideline concordant breast cancer care.

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Abstract Details

Meeting

2014 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

General Poster Session B: Cost, Value, and Policy in Quality and Practice of Quality

Track

Practice of Quality,Cost, Value, and Policy in Quality

Sub Track

Learning from Projects Done in a Health System

Citation

J Clin Oncol 32, 2014 (suppl 30; abstr 124)

DOI

10.1200/jco.2014.32.30_suppl.124

Abstract #

124

Poster Bd #

E14

Abstract Disclosures