title: Breast cancer center: improving access to patient care.
abstract: To improve access for patients to the Breast Cancer Center at Roswell Park Cancer Institute, the Opportunities for Improvement Project team defined 3 goals: reduce the delay to initial appointment, reduce delays in treatment at the Breast Cancer Center, and reduce delays in the start of endocrine therapy. The team developed a set of tools using Lean methodology that helped to address variables contributing to inefficiencies that result in delays. The idea behind these tools was to integrate all the business variables, such as volume, clinical space, physician availability, services offered in the Breast Program, and patient types, to produce a system or schedule that is more predictable. A new schedule for physicians, independent mid-level clinics, a survivorship program, a primary nursing model, and new roles and responsibilities were defined and implemented. Mean scores in a Press Ganey survey for wait-time questions improved by 10 points, and patient complaints decreased by almost 40%. The team concluded that delays in the Breast Program were symptoms of a larger dysfunction in systems. Fixing the problems required a comprehensive approach to review all the variables that resulted in delays.
authors.affiliation: From aRoswell Park Cancer Institute, Buffalo, New York, and bBaptist Cancer Center, Baptist Memorial Health Care Corporation, Memphis, Tennessee.
authors.forename: Jatinder
authors.initials: J
authors.lastname: Singh
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Edge
authors.forename: Ermelinda
authors.initials: E
authors.lastname: Bonaccio
authors.forename: Kathleen Trapp
authors.initials: KT
authors.lastname: Schwert
authors.forename: Brian
authors.initials: B
authors.lastname: Braun
mesh_terms: D001071:Appointments and Schedules; D001943:Breast Neoplasms / Q000175:diagnosis / Q000628:therapy; D002173:Cancer Care Facilities; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D009518:New York; D017060:Patient Satisfaction; D011785:Quality Assurance, Health Care; D058996:Quality Improvement; D017741:Survivors; D013997:Time Factors