Same-Day Surgery for Mastectomy Patients in Alberta: A Perioperative Care Pathway and Quality Improvement Initiative

Keehn, Alysha; Olson, David; Dort, Joseph C.; Parker, Shannon; Anderes, Susan; Headley, Lynn; Elwi, Adam; Estey, Angela; Crocker, Alysha; Laws, Alison; Quan, May Lynn

doi:10.1245/s10434-019-07568-5

Cited by 24 publications

(29 citation statements)

References 17 publications

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“…Similarly, Vuong et al reported successful implementation of a pilot postmastectomy home recovery program, demonstrating low rates of emergency department visits or re-admission for discharged patients [13]. In a recent study conducted by Keehn et al, the authors reported the release of nearly 831 hospital beds across 13 hospitals in Alberta, Canada, per year due to their same-day surgery pathway, with no difference in postoperative complication or hospital re-admission when compared to those admitted overnight per traditional mastectomy protocol [14].…”

Section: Electronic Supplementary Materialsmentioning

confidence: 99%

High-Efficiency Same-Day Approach to Breast Reconstruction During the COVID-19 Crisis

Specht

Sobti

Rosado

et al. 2020

Breast Cancer Res Treat

114

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Purpose As our hospitals conserve and re-allocate resources during the COVID-19 crisis, there is urgent need to determine how best to continue caring for breast cancer patients. During the time window before the COVID-19 critical peak and particularly thereafter, as hospitals are able to resume cancer operations, we anticipate that there will be great need to maximize efficiency to treat breast cancer. The goal of this study is to present a same-day protocol that minimizes resource utilization to enable hospitals to increase inpatient capacity, while providing care for breast cancer patients undergoing mastectomy and immediate breast reconstruction during the COVID-19 crisis. Methods IRB exempt patient quality improvement initiative was conducted to detail the operationalization of a novel same-day breast reconstruction protocol. Consecutive patients having undergone immediate breast reconstruction were prospectively enrolled between February and March of 2020 at Massachusetts General Hospital during the COVID-19 crisis. Peri-operative results and postoperative complications were summarized. Results Time interval from surgical closure to patient discharge was 5.02 ± 1.29 h. All patients were discharged home, with no re-admissions or emergency department visits. No postoperative complications were observed. Conclusion This report provides an instruction manual to operationalize a same-day breast reconstruction protocol, to meet demands of providing appropriate cancer treatment during times of unprecedented resource limitations. Pre-pectoral implantbased breast reconstruction can be the definitive procedure or be used as a bridge to autologous reconstruction. Importantly, we hope this work will be helpful to our patients and community as we emerge from the COVID-19 pandemic.

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Section: Electronic Supplementary Materialsmentioning

confidence: 99%

High-Efficiency Same-Day Approach to Breast Reconstruction During the COVID-19 Crisis

Specht

Sobti

Rosado

et al. 2020

Breast Cancer Res Treat

114

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“…In total 884 bed-days were released in 2018/19 compared with 2011/12. 10 Over the past 7 years, the CSCN network has grown in size and diversity, broadening its scope of work and learning along the way. Starting with defined projects that were feasible and could be completed in a short time enabled the network to show its value, build credibility and establish methodologies (quality improvement, implementation and measurement expertise) that were applied to more complex projects.…”

Section: Key Pointsmentioning

confidence: 99%

Cancer Strategic Clinical Network

Bond

Estey

Elwi

2019

CMAJ

Self Cite

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“…Just some of the highlighted research studies published in this issue of Annals of Surgical Oncology include essential work regarding nipplesparing mastectomy and patient-reported outcomes based on type of breast cancer surgery and reconstruction received. [2][3][4][5][6][7][8] The annual Scientific Presentation Award for the best presentation by a fellow/resident/or trainee went to Dr. Olga Kantor for her work on physician knowledge regarding contralateral prophylactic mastectomy, and both the Scientific Impact Award for the best presentation as voted by the attendees and the George Peter's Award for the best presentation by a fellow went to Dr. Susie Sun for her work on selecting patients for non-operative management clinical trials after neoadjuvant systemic therapy. 9,10 Finally, ensuring the best quality comprehensive breast care today and the future requires healthy surgeons and teams taking care of our patients.…”

Section: Oral and Scientific Sessionsmentioning

confidence: 99%

Comprehensive Breast Care for the Future from the American Society of Breast Surgeons

Holmes

Kuerer

2019

Ann Surg Oncol

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Same-Day Surgery for Mastectomy Patients in Alberta: A Perioperative Care Pathway and Quality Improvement Initiative

Cited by 24 publications

References 17 publications

High-Efficiency Same-Day Approach to Breast Reconstruction During the COVID-19 Crisis

High-Efficiency Same-Day Approach to Breast Reconstruction During the COVID-19 Crisis

Cancer Strategic Clinical Network

Comprehensive Breast Care for the Future from the American Society of Breast Surgeons

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