Division of General Surgery, Ottawa Hospital, Suite CW 1606, General Campus, Ottawa, ON, K2C 4H2, Canada.
Ann Surg Oncol. 2013 Oct;20(10):3335-40. doi: 10.1245/s10434-013-3120-5. Epub 2013 Aug 22.
The diagnostic phase of care is an anxiety-provoking and stressful experience for the potential breast cancer patient. A multidisciplinary team of breast cancer specialists embarked on a new initiative to pilot a Rapid Diagnosis and Support (RADS) Clinic to coordinate the diagnostic workup and nursing support for patients with a high probability of breast cancer.
Consecutive patients with an initial diagnostic imaging classified as BI-RADS 5 were invited to participate in this 1-year prospective study. Coordination of diagnostic imaging workup and nursing support were provided by a nurse navigator. Wait times were evaluated at several intervals of care. Satisfaction surveys were given to study participants and compared to scores from patients who did not go through RADS clinic.
A total of 211 patients participated in the RADS clinic. Biopsy wait times improved from a mean of 7 to 3 days (p < 0.001), pathology from 3.9 to 3.3 days (p < 0.001), surgical consultation from 16.1 to 5.9 days (p < 0.001), and operative wait times from 31.5 to 24.1 days (p = 0.042). There was a 95.3 % satisfaction rate with the RADS clinic with significantly improvement in patients' sense of an understanding of the treatment plan (p = 0.031), timeliness of tests (p = 0.045), and timeliness of results (p = 0.0419).
The RADS clinic significantly improved diagnostic wait times and satisfaction scores for patients with a high probability of diagnosis of breast cancer and can serve as an innovative service delivery model for other breast care centers.
对于潜在的乳腺癌患者来说，诊断阶段的护理既令人焦虑又倍感压力。一个由乳腺癌专家组成的多学科团队启动了一项新的计划，试点快速诊断和支持 (RADS) 诊所，以协调高概率乳腺癌患者的诊断工作和护理支持。
连续邀请初始诊断影像学分类为 BI-RADS 5 的患者参加这项为期 1 年的前瞻性研究。诊断影像学检查和护理支持的协调由护士导航员提供。在几个护理间隔评估等待时间。向研究参与者发放满意度调查，并与未经过 RADS 诊所的患者的评分进行比较。
共有 211 名患者参加了 RADS 诊所。活检等待时间从平均 7 天缩短至 3 天（p < 0.001），病理时间从 3.9 天缩短至 3.3 天（p < 0.001），外科咨询时间从 16.1 天缩短至 5.9 天（p < 0.001），手术等待时间从 31.5 天缩短至 24.1 天（p = 0.042）。RADS 诊所的满意度为 95.3%，患者对治疗计划的理解程度（p = 0.031）、检查的及时性（p = 0.045）和结果的及时性（p = 0.0419）均有显著改善。
RADS 诊所显著缩短了高概率乳腺癌患者的诊断等待时间和满意度评分，可为其他乳腺护理中心提供创新的服务提供模式。
