title: Improving breast diagnostic services with a Rapid Access Diagnostic and Support (RADS) program.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors: Division of General Surgery, Ottawa Hospital, Suite CW 1606, General Campus, Ottawa, ON, K2C 4H2, Canada. anarnaout@toh.on.ca
authors: Angel
authors: A
authors: Arnaout
authors: Jennifer
authors: J
authors: Smylie
authors: Jean
authors: J
authors: Seely
authors: Susan
authors: S
authors: Robertson
authors: Kathy
authors: K
authors: Knight
authors: Salome
authors: S
authors: Shin
authors: Tim
authors: T
authors: Ramsey
authors: Ranjeeta
authors: R
authors: Mallick
authors: James
authors: J
authors: Watters
mesh_terms: D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000175:diagnosis*; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis*; D018275:Carcinoma, Lobular / Q000175:diagnosis*; D003954:Diagnostic Services; D055088:Early Detection of Cancer; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D009367:Neoplasm Staging; D010865:Pilot Projects; D011379:Prognosis; D011856:Radiographic Image Enhancement; D012189:Retrospective Studies