Healthcare systems are constantly expanding and gaining new territories. This growth is met with challenges in the organization and delivery of quality health care services to a large geographical area. The need for provider and staff coverage at the new sites often outpaces the rate at which additional providers and staff are hired. The need for new technology, equipment, and administrative support to oversee the new sites may also lag. The overall result could compromise patient experience at these outlying locations. The breast imaging division at University Hospitals Cleveland Medical Center (UHCMC) instituted many changes to support UHCMC’s continual growth while focusing on consistent quality of care and optimal patient experience. Changes included adoption of the hub-and-spoke organization-design model and incorporation of the integrated practice unit (IPU) concept. In the hub-and-spoke organization-design model, full services are offered at a central hub, with additional limited services provided at the peripheral spoke sites. The IPU is a dedicated team of clinical and nonclinical personnel providing the full care cycle centered on a specific medical condition such as breast health. The breast imaging hubs and spokes are incorporated into the breast health IPUs to provide uniform quality care across a large health system. The purpose of this article is to describe how the breast imaging division, functioning as members of the breast care IPU, utilized the hub-and-spoke concept to provide quality breast imaging services throughout the expanding health system.
Breast cancer in men is rare and often overlooked as there is a misconception that it is a gendered disease that affects women only. The feminization, or “pinkification,” of the disease has been socially constructed to raise awareness, improve screening, and empower women but has not addressed the occurrence of the illness in men. Men may therefore experience unique psychosocial difficulties when faced with a disease that predominantly affects women, including feelings of disbelief and embarrassment that impact their sense of self and challenge their masculinity. The lack of mammographic screening in men, lack of public awareness, and the shame that develops during the time of diagnosis can result in treatment avoidant behaviors, a delayed presentation, and worse prognosis in men. Although male breast cancer (MBC) is uncommon, the incidence is increasing; therefore, efforts should be made to enhance education for health care professionals and the general public in order to lessen the stigma, with the goal of improving outcomes. Furthermore, special attention to the unique medical needs and hurdles encountered by transgender males can break down health care barriers in this marginalized patient population. This article offers male perceptions on breast cancer, the psychosocial implications of being diagnosed with a gendered disease, and suggestions on how to improve the MBC experience.
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