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Improving Efficiency of Practice through Breast Reduction Education and Screening Program
Rae Hiller, Binh Nguyen, Sarah Wilkey, Sarah Wipperman, John Kitzmiller
University of Cincinnati Plastic Surgery
2016-02-29
Presenter: Bing Nguyen
Affidavit:
100% analysis and interpretation of data
100% drafted or provided critical revision of the abstract
Director Name: John Kitzmiller
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Background:
Evaluating candidates for non-cosmetic reduction mammoplasty can be resource intensive and low yield. At our institution, physician extender based programs were implemented to educate and screen patients prior to final consultation with a surgeon. The aim of this study is to determine whether such programs can improve efficiency by targeting higher volumes of patients while saving unproductive surgeon time.
Methods:
Retrospective chart reviews were performed on all patients interested in non-cosmetic breast reduction, who enrolled in the Breast Reduction Education and Screening (BRES) program at the University of Cincinnati between the periods of June through December 2015. Specific data collected include attendance, surgical candidate eligibility (BMI, tobacco use, comorbidities, etc), insurance approval, and reduction mammoplasty surgeries. Charts of patients scheduled for initial consultation by a surgeon at the University of Cincinnati between the representative periods of November and December 2014 (pre-BRES program), were also examined for comparison.
Results:
Scheduled patient evaluation doubled after implementation of BRES compared to pre-BRES (avg 20 vs 9 patients/month). 72% (n=88) of patients enrolled in BRES were either not eligible candidates for surgery (n=31) or no showed (n=57). This is equivalent to 44 hours of estimated unproductive surgeon consultation time. Of the remaining 28% (n=33) meeting screening criteria, only 15% (n=5) eventually underwent surgery. The remaining 85% (n=28) either no showed (n=7), were denied by insurance (n=14), or failed the cotinine test (n=4).
Conclusion:
BRES can target more patients, help identify eligible candidates for consultation and surgery, and reduce unproductive surgeon consultation time.
