title: Positive impact of a breast-health triaging system on breast-care access and physician satisfaction.
abstract: OBJECTIVE
  Minority patients are at risk for delayed breast cancer treatment. Using nonsurgical breast specialists could improve access but requires appropriate referral to ensure prompt cancer care. Our objective was to evaluate a referral triage system in a combined medical/surgical breast health program (BHP).
  
  
  METHODS
  A triage system based on imaging findings, examination, and patient age was instituted. An advanced practice nurse managed referrals and a prospective database. Referring providers were surveyed after 2 years.
  
  
  RESULTS
  From 2003 to 2006, 4,840 referrals were made to surgeons (57%) and nonsurgeons (43%). Breast cancers were found in 8.5% of patients. Referral error occurred in 4 cancer patients (.1%). BHP-referred patients had significantly shorter times to surgical appointment (10 days) than non-BHP referrals (45 days). A referring provider survey indicated 96% satisfaction.
  
  
  CONCLUSIONS
  A breast-care triage system expedited cancer care resulting in physician satisfaction and increased referrals.
authors.affiliation: Department of Surgery, Boston Medical Center, Boston University School of Medicine, Suite D-604, 88 East Newton Street, Boston, MA 02118, USA. michael.stone@bmc.org
authors.forename: Michael D
authors.initials: MD
authors.lastname: Stone
authors.forename: Sheila
authors.initials: S
authors.lastname: Norton
authors.forename: Jane E
authors.initials: JE
authors.lastname: Mendez
authors.forename: Erwin
authors.initials: E
authors.lastname: Hirsch
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000628:therapy*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007588:Job Satisfaction; D008913:Minority Groups; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D014218:Triage; D014481:United States