乳腺癌手术咨询集中化后的手术机会。
Access to surgery following centralization of breast cancer surgical consultations.
机构信息
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.
出版信息
Am J Surg. 2020 May;219(5):831-835. doi: 10.1016/j.amjsurg.2020.01.050. Epub 2020 Jan 31.
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.
简介
及时进行乳腺癌手术对患者的预后至关重要。在我们之前的模型基础上，5 位乳腺外科医生采用集中式录入和护士导航分诊的原则，集中处理所有乳腺外科转诊。本研究的目的是调查集中化是否可以进一步改善手术的可及性。
方法
本研究设计为前后系列比较，比较集中化前和集中化后乳腺癌手术的等待时间。主要结果是从诊断到手术的等待时间，次要结果包括中位数等待时间、完成 90%病例所需的天数、可用手术日数量以及接受乳房重建和新辅助治疗的患者数量。
结果
总体而言，乳腺外科转诊的集中化将等待时间从 47 天缩短至 41 天。尽管手术室的可用性减少了 7%，但中位数等待时间和完成 90%病例所需的时间都有所缩短。集中化后，接受新辅助治疗的患者减少，接受乳房重建的患者增加。
结论
集中处理乳腺癌患者的手术转诊可改善手术的可及性。
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