For many women, the stress and uncertainty of not knowing the results of a postmammogram biopsy are almost worse than a positive diagnosis.
As executives of Elkhart (Ind.) General Healthcare System considered opening a breast cancer clinic in June 2000, they knew the waiting period had to be shortened.
"We found we were taking between seven and nine days to let a woman know the results from an abnormal mammogram and biopsy," says Pamela Frye, a registered nurse who is director of oncology and women's services for the system, the parent company of 337-bed Elkhart General Hospital. "That meant a lot of unnecessary sleepless nights. We discovered that the biggest holdup was in the pathology reports." The system succeeded in slashing the waiting time roughly in half.
For its accomplishments and the team's creativity in achieving them, judges named Elkhart General Healthcare System this year's winner in the internal service category of the Sodexho competition.
The system joined a national program called "Deciding What Care Is Right for Breast Cancer," sponsored by the Irving, Texas-based VHA alliance. That program explores the latest technologies and evidence-based treatments for the disease, including speeding early diagnosis by increasing mammograms and reducing turnaround time for biopsy results. Elkhart formed a multidisciplinary team that included a surgeon, a radiologist, a radiation oncologist, nurses, a cancer registrar and mammographers to examine how breast cancer is diagnosed.
The project team discussed the pathology logjam and other process problems early in the yearlong project. The staff and pathologists decreased the turnaround in issuing and distributing reports. The American Cancer Society's accepted standard of care was seven days from abnormal mammogram to diagnosis, a better performance than the eight to nine days the hospital had been averaging. Since the team's intervention, Elkhart General has reduced that turnaround time to an average of four days, and frequently to as few as two days.
Last year, it established a breast cancer clinic, and through community education programs and presentations to local doctors increased screening mammograms by 24% and boosted the number of total mammograms performed by 14%. Patient- satisfaction scores also improved, by 83% from the time of the project's inception in June 2000 to a year later.