Centralization improves care processes, reports Plastic and Reconstructive Surgery
After opening a comprehensive breast center (CBC), one hospital achieved significant improvement in key measures of quality of care for women undergoing breast reconstruction, reports the November issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).
Centralized breast cancer care at CBCs can lead to more timely breast reconstruction for women undergoing breast cancer surgery, suggests the study by ASPS Member Surgeon Albert H. Chao, MD, and colleagues of The Ohio State University, Columbus. They write, "Access to breast reconstruction at our institution improved significantly after our CBC opened, with significant increases in internal referral rates and immediate reconstruction rates."
Transition to CBC Improves Processes of Care
The researchers assessed "process of care" outcomes related to breast reconstruction before and after their hospital transitioned to a CBC approach. Comprehensive breast centers seek to improve patient care and outcomes by assembling a group of highly specialized practitioners—oncologists, plastic and reconstructive surgeons, and other professionals—to provide coordinated breast cancer care. The study compared 614 women treated for breast cancer before the CBC transition and 750 women treated afterward.
Surgical oncologists (breast cancer surgeons) at the hospital saw about the same number of patients during both periods. However, after the CBC transition, patients were more likely to be referred to a plastic surgeon for breast reconstruction. The referral rate increased from about 27 percent to 46 percent.
Women treated in the CBC were also referred more promptly for breast reconstruction. "The time between surgical oncology consultation and plastic surgery consultation decreased from 10.5 days to 3.6 days," Dr Chao and coauthors write. The percentage of patients who saw that breast cancer surgeon and plastic surgeon on the same day increased from 6.5 percent before the CBC was opened, to 50 percent afterward.
Improved Access to Timely Breast Reconstruction
For women who underwent mastectomy, the CBC approach increased the rate of immediate breast reconstruction: from about 40 percent to over 52 percent. In this group, the time between the plastic surgery visit and mastectomy/breast reconstruction decreased from about 42 days to 30 days.
Rates of important types of complications after breast reconstruction surgery were about the same before and after the CBC approach.
Because long-term follow-up is needed to assess the oncologic outcomes of breast cancer (survival, etc), studies of the quality of care provided at CBCs have focused on processes of care. The new experience suggests that large hospitals transitioning to the CBC approach may be able to offer breast reconstruction to more patients, with shorter times to plastic surgery referral.
Dr Chao and coauthors write, "A new diagnosis of breast cancer can be distressing for a patient, and every day that passes between the time the diagnosis is made and the time treatment is administered can increase a patient's anxiety." In the CBC approach, breast reconstruction consultations for new patients were scheduled in the afternoon, to enable more patients to have their surgical oncology and plastic surgery visits on the same day.
The researchers also note that the CBC approach was "financially sustainable" for their hospital, even after the investment in resources devoted to breast reconstruction. Dr Chao and colleagues conclude, "In breast reconstruction, a comprehensive breast center improves processes of care, and underscores the importance of plastic surgery involvement within these centers."
Plastic and Reconstructive Surgery® is published by Lippincott Williams & Wilkins, part of Wolters Kluwer Health.
About Plastic and Reconstructive Surgery
For more than 60 years, Plastic and Reconstructive Surgery®, has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. The official journal of the American Society of Plastic Surgeons, Plastic and Reconstructive Surgery® brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair, and cosmetic surgery, as well as news on medico-legal issues.
The American Society of Plastic Surgeons (ASPS) is the world's largest organization of board-certified plastic surgeons. Representing more than 7,000 Member Surgeons, the Society is recognized as a leading authority and information source on aesthetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada. ASPS advances quality care to plastic surgery patients by encouraging high standards of training, ethics, physician practice and research in plastic surgery. You can learn more and visit the American Society of Plastic Surgeons at http://www.plasticsurgery.org or http://www.facebook.com/PlasticSurgeryASPS and http://www.twitter.com/ASPS_news .
About Wolters Kluwer Health
Wolters Kluwer Health is a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Serving more than 150 countries worldwide, clinicians rely on Wolters Kluwer Health's market leading information-enabled tools and software solutions throughout their professional careers from training to research to practice. Major brands include Health Language®, Lexicomp®, Lippincott Williams & Wilkins, Medicom®, Medknow, Ovid®, Pharmacy OneSource®, ProVation® Medical and UpToDate®.
Wolters Kluwer Health is part of Wolters Kluwer, a market-leading global information services company. Wolters Kluwer had 2013 annual revenues of €3.6 billion ($4.7 billion), employs approximately 19,000 people worldwide, and maintains operations in over 40 countries across Europe, North America, Asia Pacific, and Latin America.maintains operations in over 40 countries across Europe, North America, Asia Pacific, and Latin America. Wolters Kluwer is headquartered in Alphen aan den Rijn, the Netherlands. Its shares are quoted on Euronext Amsterdam (WKL) and are included in the AEX and Euronext 100 indices. Wolters Kluwer has a sponsored Level 1 American Depositary Receipt program. The ADRs are traded on the over-the-counter market in the U.S. (WTKWY).
Connie Hughes | EurekAlert!
Penn vet research identifies new target for taming Ebola
12.01.2017 | University of Pennsylvania
The strange double life of Dab2
10.01.2017 | University of Miami Miller School of Medicine
Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.
As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...
At TU Wien, an alternative for resource intensive formwork for the construction of concrete domes was developed. It is now used in a test dome for the Austrian Federal Railways Infrastructure (ÖBB Infrastruktur).
Concrete shells are efficient structures, but not very resource efficient. The formwork for the construction of concrete domes alone requires a high amount of...
Many pathogens use certain sugar compounds from their host to help conceal themselves against the immune system. Scientists at the University of Bonn have now, in cooperation with researchers at the University of York in the United Kingdom, analyzed the dynamics of a bacterial molecule that is involved in this process. They demonstrate that the protein grabs onto the sugar molecule with a Pac Man-like chewing motion and holds it until it can be used. Their results could help design therapeutics that could make the protein poorer at grabbing and holding and hence compromise the pathogen in the host. The study has now been published in “Biophysical Journal”.
The cells of the mouth, nose and intestinal mucosa produce large quantities of a chemical called sialic acid. Many bacteria possess a special transport system...
UMD, NOAA collaboration demonstrates suitability of in-orbit datasets for weather satellite calibration
"Traffic and weather, together on the hour!" blasts your local radio station, while your smartphone knows the weather halfway across the world. A network of...
Fiber-reinforced plastics (FRP) are frequently used in the aeronautic and automobile industry. However, the repair of workpieces made of these composite materials is often less profitable than exchanging the part. In order to increase the lifetime of FRP parts and to make them more eco-efficient, the Laser Zentrum Hannover e.V. (LZH) and the Apodius GmbH want to combine a new measuring device for fiber layer orientation with an innovative laser-based repair process.
Defects in FRP pieces may be production or operation-related. Whether or not repair is cost-effective depends on the geometry of the defective area, the tools...
10.01.2017 | Event News
09.01.2017 | Event News
05.01.2017 | Event News
16.01.2017 | Power and Electrical Engineering
16.01.2017 | Information Technology
16.01.2017 | Power and Electrical Engineering