South Island Island Integrated Breast Cancer Care Program


Project Details

  • Departments/Divisions: General Surgery, Medical Oncology, Radiation Oncology
  • Physician Leads: Dr. Heather Emmerton-Coughlin, General Surgery; Dr. Elaine Lam, General Surgery
  • Budget: $10,247.00

About the Project

Patients facing a breast cancer diagnosis want the fastest possible route to quality care; however, breast cancer wait times among surgeons vary considerably. Breast cancer surgeon specialists Dr. Heather Emmerton-Coughlin and Dr. Elaine Lam wanted to improve the wait times associated with breast cancer surgery while maintaining world class quality and respecting patient preferences for their journey.

Drawing on support from the South Island MSA’s Facility Engagement funding, the physicians used dedicated grant funding to meet with the various specialties and stakeholders involved in South Island breast cancer care.  This included medical oncologists, pathologists, radiation oncologists, general surgeons, and family physicians, as well as breast cancer specialist nurses Ly Stewart and Shawna Bond, Executive Medical Director for Surgery and Ambulatory Care Dr. William Orrom, and colleagues from Island Health Surgical Services.  These meetings were to build consensus around the need for a centralized referral process and first available surgeon option for breast cancer surgery.

Although it was clear that a single-entry, quality-assured, integrated breast cancer program would benefit all South Island patients, three crucial elements were required: the need for a dedicated Referral Clerk to manage referrals, a way to determine first available surgery dates amongst all providers, and the creation of a single unified database to monitor and track referrals and collate quality data. Once these elements were determined the project progressed quickly.

Working with Erin Corry, an experienced Project Manager for Island Health Surgical Services, and Kyra Siemens, Manager, Surgical Waitlist Management, the group developed the workflows, policies, and procedures to govern the First Available Surgeon option, as well as create the necessary communications and promotional materials for the initiative. They also realized an additional opportunity that bringing all patients together through a centralized referral process affords: Not only does this system help to streamline the connection with a patient and her surgeon, it also provides an opportunity to evaluate the patient experience beyond just surgical wait times – such as a survey of how patients are affected by those wait times, how health care processes affect their cancer care journey, and the long term outcome measures that matter to patients most. The group hopes to use these data to continue to improve breast cancer services.

Speaking about the process, Dr. Emmerton-Coughlin noted the importance of aligning their project initiatives with the wider priorities of the Health Authority. Having funding to support sessionals was crucial to gathering physicians together to “ask the right questions”, said Dr. Emmerton-Coughlin.

The group has now received further support from the Enhancing Access initiative, another branch of the Specialist Services Committee’s specifically focused on improving timely access to specialist care through a pooled referral model. More information about this initiative can be found here.

As a testament to the value of the project and the promotion it has received within the Health Authority, the initiative has seen considerable success in its first month:  Primary Care Providers have embraced the referral form, and 83% of referrals are for First Available Surgeon. All of this means that patients will receive more timely access to care.

More information about the South Island Integrated Breast Cancer Program can be found on Island Health’s website.


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