Allina Health Breast Program has been recognized for work that began three years ago to ensure that patients receive consistently exceptional breast cancer care from diagnosis to recovery across the Allina Health system.
The Virginia Piper Cancer Institute® – Abbott Northwestern Hospital in Minneapolis, the Virginia Piper Cancer Institute® – Unity Hospital in Fridley, the Mercy Hospital Cancer Program in Coon Rapids and the United Hospital Cancer Program in St. Paul have been selected to receive the Association of Community Cancer Centers 2012 Innovator Award.
“It takes a long time to change outcome data, but if you concentrate on improving processes, you will improve outcomes,” said Dr. Dan Dunn, a surgeon and chairman of the Allina Health Breast Program committee that includes 48 physicians, nurses, hospital support staff and managers.
The committee based its work on 31 nationally-accepted quality guidelines.
Allina hospitals sometimes performed above the national levels. Eventually, the committee agreed on a set of systemwide guidelines.
New work processes were created where needed, and practice is measured with the expectation that compliance will positively affect patient care, experience and survival.
Examples of system-wide guidelines that led to the innovation award:
• How much healthy tissue surgeons remove along the margins of cancerous tissue.
• How surgery specimens are handled in the operating room and prepared for analysis in the lab.
• How the lab determines margin status while the patient is still in surgery.
“Margin status is the most important aspect in the surgical management of a patient receiving breast conserving therapy,” Dunn said.
“Margin status affects whether you remove more tissue. Margin status affects local recurrence rates and ultimately, margin status affects the survival of the patient.”
Prepping specimens in a consistent and timely way impacts the accuracy of the patient’s diagnosis, and ultimately sets the course for their treatment and long-term outcomes, according to Dr. Tamera Lillemoe, a pathologist and breast committee member.
A patient advisory committee also influences the breast committee. One of its first recommendations was that patients should receive a needle biopsy the same day as the diagnostic work-up, since a delay in diagnosis is so stressful. Breast centers joined together, analyzed their workflow and increased from 50 to 70 percent of patients receiving same-day needle biopsies.