Understanding and Optimizing the Patient Experience in Breast Reconstruction

Abstract

Background Optimizing the patient experience is a central pillar in healthcare quality. While this may be recognized as important in breast reconstruction, surgeons are often unaware of how well they and members of their team achieve this goal. The objective of our study was to evaluate patient satisfaction with the experience of care in a multicenter, prospective cohort of patients undergoing breast reconstruction. Specifically, we sought to determine which aspects of the care experience might be most amenable to quality improvement. Methods As part of the Mastectomy Reconstruction Outcomes Consortium Study (MROC), 2,093 patients were recruited from 11 centers in North America. Of these, 1,534 (73.3%) completed the BREAST-Q Satisfaction with Care scales (Satisfaction with Information, Surgeon, Medical team, and Office staff) at three months post-reconstruction and were included in the analysis. Results Patients scored lowest on ‘Satisfaction with Information’ (mean = 72.8) compared to all other Satisfaction with Care scales (means: 89.5 - 95.5). Patients with immediate reconstruction were less satisfied with their plastic surgeon compared to those with delayed reconstruction. The racial category, “Other” (Asians, Pacific Islanders, Hawaiians, American Indians), was the least satisfied group across all Satisfaction with Care scales. Conclusion Patients undergoing breast reconstruction perceive significant gaps in their knowledge and understanding of expected outcomes. Immediate reconstruction patients and minority racial groups may require additional resources and attention. As a means to improve quality of care, these findings highlight an important unmet need and suggest that improving patient education may be central to providing patient-centered care.

Predictive factors of satisfaction and quality of life after immediate breast reconstruction using the BREAST‐Q©

“…Our results were similar to those of Cohen et al. () and contrasted the difference in terms of satisfaction with the information (mean = 72.8) vs. satisfaction with the care received (mean = 89.5–95.5), suggesting the need to improve the information in order to provide patient‐centred care.…”

Exploring the Role of Partner Satisfaction in Predicting Patient Satisfaction Regarding Post-mastectomy Breast Reconstruction

“… 8 , 9 Broadly, 3 themes continued to reemerge throughout the literature: disappointment with preoperative counseling, avoidance of sexual contact postoperatively, and unsatisfactory postoperative communication between partners. 3 , 5 , 10 – 12 These studies have largely relied on open-ended questions, restricting the analyses to identification of common themes and qualitative data.…”

A Prospective Study Assessing Complication Rates and Patient-Reported Outcomes in Breast Reconstructions Using a Novel, Deep Dermal Human Acellular Dermal Matrix

“… 19 – 25 These subjective outcomes are positively associated with objective outcomes like clinical effectiveness and patient safety. 26 , 27 BREAST-Q (Memorial Sloan-Kettering Cancer Center, New York, N.Y.) is a validated survey instrument designed to quantify patient-reported outcomes in breast surgery 28 , 29 and has been successfully employed to understand how key perioperative variables impact the patient experience. For example, patients undergoing perioperative radiation therapy scored lower on all scales of the BREAST-Q©.…”