After a full year of preparation, the surveyor for the National Accreditation Program for Breast Centers (NAPBC) made a site visit for evaluation of our program.
It was a tense few days getting the last-minute documentation for his review, but after a full day, he was able to recommend passing our fledgling program. National accreditation would give our community the confidence that our breast program succeeded in achieving 17 rigorous standards of care.
Standards include: organizational accountability of the breast leadership committee; following national guidelines for care such as the NCCN, ONS, and ASCO; the presence of a nurse navigator to follow patients from diagnosis to survivorship; and credentialing of all staff of the breast center.
We also had to show community involvement with educational symposia and early detection activities, and have significant support services such as palliative care, lymphedema management, and psychosocial therapy as needed.
One of the most critical aspects of our program is to self-evaluate with yearly quality improvement measures. I believe that going through this process together (there are 20 people on the committee, half whom are interested physician partners of all appropriate oncology specialties), we have become a more cohesive, comprehensive team, which benefits our patients. We always had excellent services and physicians for breast health, but it seemed a bit fragmented. Now we can meet over dinner on a quarterly basis, discuss new prospective cases each week over breakfast, and create consensus on policy and treatment decisions.
A few must-haves for success:
- Have administration buy-in. If this is a goal that has real benefit to the hospital and the community and there is a champion within administration, rarely can you fail.
- Have physician champions who are willing to give extra time to organizing and sustaining a program, which means extra meetings and decision making. This role can be filled with political potholes, so a strong person in this role is essential.
- Have dedicated staff and navigator who have only the best interest in breast cancer patients and their unique needs. Building a resource list that can be of use to patients goes a long way toward good will within the community. I can say that I often surprise patients when I call just to see how they are doing months after their surgery.
- Moving a group to a common goal is not easy, but it can often be achieved with commitment to the overarching principles of patient care and compassion for the cancer patient. I began by introducing myself to each physician and asked for their support. I became familiar with their office staff members. When you think like a team, you become a team.
I am so profoundly proud of the professionals who have helped this program grow and become accredited. There is always room for improvement, and we will strive for even better quality outcomes in future years.
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