Does offering immediate breast reconstruction after MRI to women with breast cancer increase the chance of breaching the "NHS cancer time to treatment target"?
Association of Breast Surgery ePoster Library. Almerie M. 05/15/17; 166251; P035
Mr. Muhammad Qutayba Almerie
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Abstract
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Introduction: Within our unit, offering immediate breast reconstruction to breast cancer patients after MRI resulted in an unacceptable level of breaches to target dates. This management audit aimed to determine and then address the rate limiting factors within this treatment pathway to achieve a more streamlined patient service.
Method: The electronic notes of all breast cancer patients with immediate reconstruction after MRI between Jan-Oct 2015 were reviewed. Patients who underwent neo-adjuvant chemotherapy were excluded. The timeline of each patient including the referral route, clinics, investigations, MDT discussions and treatment dates were created to determine the rate limiting factors.
Results: Analysis of phase 1 (Jan-Mar 2015) showed 30% breaches to the 62-day target. Delay in MRI's and second-look biopsies turnaround time was a causative factor (table-1). Recommendations to tighten-up delays in these two areas were implemented partially over phase-2 (Apr-Jun 2015) and fully over phase-3 (Aug-Oct 2015) and the service was re-audited over these periods.
Turnaround times for MRI and second look biopsies dropped from 20 and 22 days in phase-1 to 9 and 14 days in phase-3, respectively. Breaches also decreased to 21% in phase-2 and further to 0% in phase-3. Symptomatic patients were more likely to breach (35%) in comparison to screening (7%) and surveillance patients (0%).
Conclusion: Offering immediate breast reconstruction following MRI can potentially put pressure on delivering the cancer-treatment targets. However, allowing enough time for patients to decide on the type of reconstruction is invaluable. Refining our pathway significantly reduced MRI turnaround time, thus allowed increased time for adequate patient consideration, without fearing the financial penalties incurred by breaching target dates.
Method: The electronic notes of all breast cancer patients with immediate reconstruction after MRI between Jan-Oct 2015 were reviewed. Patients who underwent neo-adjuvant chemotherapy were excluded. The timeline of each patient including the referral route, clinics, investigations, MDT discussions and treatment dates were created to determine the rate limiting factors.
Results: Analysis of phase 1 (Jan-Mar 2015) showed 30% breaches to the 62-day target. Delay in MRI's and second-look biopsies turnaround time was a causative factor (table-1). Recommendations to tighten-up delays in these two areas were implemented partially over phase-2 (Apr-Jun 2015) and fully over phase-3 (Aug-Oct 2015) and the service was re-audited over these periods.
Turnaround times for MRI and second look biopsies dropped from 20 and 22 days in phase-1 to 9 and 14 days in phase-3, respectively. Breaches also decreased to 21% in phase-2 and further to 0% in phase-3. Symptomatic patients were more likely to breach (35%) in comparison to screening (7%) and surveillance patients (0%).
Conclusion: Offering immediate breast reconstruction following MRI can potentially put pressure on delivering the cancer-treatment targets. However, allowing enough time for patients to decide on the type of reconstruction is invaluable. Refining our pathway significantly reduced MRI turnaround time, thus allowed increased time for adequate patient consideration, without fearing the financial penalties incurred by breaching target dates.
Introduction: Within our unit, offering immediate breast reconstruction to breast cancer patients after MRI resulted in an unacceptable level of breaches to target dates. This management audit aimed to determine and then address the rate limiting factors within this treatment pathway to achieve a more streamlined patient service.
Method: The electronic notes of all breast cancer patients with immediate reconstruction after MRI between Jan-Oct 2015 were reviewed. Patients who underwent neo-adjuvant chemotherapy were excluded. The timeline of each patient including the referral route, clinics, investigations, MDT discussions and treatment dates were created to determine the rate limiting factors.
Results: Analysis of phase 1 (Jan-Mar 2015) showed 30% breaches to the 62-day target. Delay in MRI's and second-look biopsies turnaround time was a causative factor (table-1). Recommendations to tighten-up delays in these two areas were implemented partially over phase-2 (Apr-Jun 2015) and fully over phase-3 (Aug-Oct 2015) and the service was re-audited over these periods.
Turnaround times for MRI and second look biopsies dropped from 20 and 22 days in phase-1 to 9 and 14 days in phase-3, respectively. Breaches also decreased to 21% in phase-2 and further to 0% in phase-3. Symptomatic patients were more likely to breach (35%) in comparison to screening (7%) and surveillance patients (0%).
Conclusion: Offering immediate breast reconstruction following MRI can potentially put pressure on delivering the cancer-treatment targets. However, allowing enough time for patients to decide on the type of reconstruction is invaluable. Refining our pathway significantly reduced MRI turnaround time, thus allowed increased time for adequate patient consideration, without fearing the financial penalties incurred by breaching target dates.
Method: The electronic notes of all breast cancer patients with immediate reconstruction after MRI between Jan-Oct 2015 were reviewed. Patients who underwent neo-adjuvant chemotherapy were excluded. The timeline of each patient including the referral route, clinics, investigations, MDT discussions and treatment dates were created to determine the rate limiting factors.
Results: Analysis of phase 1 (Jan-Mar 2015) showed 30% breaches to the 62-day target. Delay in MRI's and second-look biopsies turnaround time was a causative factor (table-1). Recommendations to tighten-up delays in these two areas were implemented partially over phase-2 (Apr-Jun 2015) and fully over phase-3 (Aug-Oct 2015) and the service was re-audited over these periods.
Turnaround times for MRI and second look biopsies dropped from 20 and 22 days in phase-1 to 9 and 14 days in phase-3, respectively. Breaches also decreased to 21% in phase-2 and further to 0% in phase-3. Symptomatic patients were more likely to breach (35%) in comparison to screening (7%) and surveillance patients (0%).
Conclusion: Offering immediate breast reconstruction following MRI can potentially put pressure on delivering the cancer-treatment targets. However, allowing enough time for patients to decide on the type of reconstruction is invaluable. Refining our pathway significantly reduced MRI turnaround time, thus allowed increased time for adequate patient consideration, without fearing the financial penalties incurred by breaching target dates.
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