Creating a Center of Excellence, or Spinning Gold From Straw

It has finally come together, and after a year that began with a gap analysis, our breast cancer specialists and hospital staff have created something wonderful.

During this remarkable year, I met so many dedicated, hard-working individuals who shared the same goal of quality care for our breast cancer patients. The physician specialists had an established referral pattern, but they had not met regularly to discuss newly diagnosed cases and best-practices in a group setting. The oncology nurses were not involved in any case review meetings, and the physical therapists who are certified as lymphedema specialists are on another campus five miles away.

The pieces of a breast program were already there. However, there was no cohesive team approach. As I have often said, it takes a village to care for a breast cancer patient from diagnosis to survivorship.

In developing a comprehensive breast cancer program that can then become accredited, these things are essential.

• Buyin: The administration and medical staff must be willing participants and keep a vested interest in the development and maintenance of a program. Representatives from each specialty should be invited to become part of a consortium of leaders on behalf of the breast cancer patient.
• Community outreach: This is the cornerstone for the program, both for the benefit of patients and for the goodwill it will provide in the community.
• Personal touches: For example, nurse navigators can be a resource for patients being treated on both an in-house and an outpatient basis. Comfort items such as pillows, camisoles, drain pouches, or small gifts to take home are truly appreciated. Once the patient is home, the nurse navigator can call and help with other issues that may arise upon discharge.
• Regular meetings with a leadership committee: Our center developed a team approach. We meet quarterly to review, create, or revise policies, action items for the coming year, and quality improvements. When members break bread together, team development soon follows.
• Getting to know the medical office staff: It is crucial to remember that they will often be the ones asked to copy, fax, and prepare materials for meetings. I like to make rounds to the various offices at different intervals, bringing holiday goodies and reminding them that they are also working to benefit the patients.

As we approach the first year of our committee and look at the strides we have made to improve the lives of our patients through the continuum of care, we should all take a collective breath and remember that a kindness done during the course of treatment is a group effort for which the patient is the biggest recipient.

Have any of you been a part of the development of a new program at your institution? If so, what types of challenges did you face?

Dedicated to the memory of Marie C. Heller, MSN, RN