Improving patient flow and timeliness in the diagnosis and management of breast abnormalities: the impact of a rapid diagnostic unit
| Autor: | Claire M. B. Holloway, J.M. Racz, W. Huang, N.J. Look Hong |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Patient anxiety Referral diagnosis wait times 03 medical and health sciences symbols.namesake Patient referral 0302 clinical medicine Breast cancer Internal medicine Biopsy medicine 030212 general & internal medicine Fisher's exact test medicine.diagnostic_test business.industry efficiencies medicine.disease Wait time Surgery Patient flow 030220 oncology & carcinogenesis symbols Original Article business |
| Zdroj: | Current Oncology Volume 23 Issue 3 Pages 3017-265 |
| ISSN: | 1198-0052 |
| Popis: | Efforts to streamline the diagnosis and treatment of breast abnormalities are necessary to limit patient anxiety and expedite care. In the present study, we examined the effect of a rapid diagnostic unit (rdu) on wait times to clinical investigations and definitive treatment. A retrospective before&ndash after series, each considering a 1-year period, examined consecutive patients with suspicious breast lesions before and after initiation of the rdu. Patient consultations, clinical investigations, and lesion characteristics were captured from time of patient referral to initiation of definitive treatment. Outcomes included time (days) to clinical investigations, to delivery of diagnosis, and to management. Groups were compared using the Fisher exact test or Student t-test. The non-rdu group included 287 patients with 164 invasive breast carcinomas. The rdu group included 260 patients with 154 invasive carcinomas. The rdu patients had more single visits for biopsy (92% rdu vs. 78% non-rdu, p < 0.0001). The rdu group also had a significantly shorter wait time from initial consultation to delivery of diagnosis (mean: 2.1 days vs. 16.7 days, p = 0.0001) and a greater chance of receiving neoadjuvant chemotherapy (37% vs. 24%, p = 0.0106). Overall time from referral to management remained statistically unchanged (mean: 53 days with the rdu vs. 50 days without the rdu, p = 0.3806). Introduction of a rdu appears to reduce wait times to definitive diagnosis, but not to treatment initiation, suggesting that obstacles to care delivery can occur at several points along the diagnostic trajectory. Multipronged efforts to reduce system-related delays to definitive treatment are needed. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|