Care Pathway Development, Implementation, and Assessment to Improve Outcomes in African American (AA) Breast Cancer Patients
AA women with breast cancer have worse overall survival compared to white women in the United States, and among major metropolitan cities, Atlanta has one of the worst disparities in outcomes. However, studies have shown that when AA women receive appropriate treatment for inflammatory breast cancer, they do not have significant differences in outcome compared with white patients. Access to care and timely therapeutic interventions are modifiable contributors to this disparity. Clinical care pathways and patient navigation help improve provider and patient adherence to standard therapy recommendations and decrease delays in treatment. We will design clinical care pathways, based on national guidelines, for breast cancer patients seen at the Emory Glenn Family Breast Center (GFBC) and Grady Memorial Hospital’s Avon Foundation Comprehensive Breast Center (AFCBC). We hope to improve the outcomes of AA patients who are most at risk for poor outcome in our community. Tumor registry data will be reviewed to determine baseline compliance rates prior to clinical pathway implementation. The hospital healthcare IT departments will work with our current electronic health record systems to integrate care pathways and develop means for monitoring compliance and providing alerts for navigators to intervene to assure appropriate and timely treatment. We will review compliance with the care pathways and need for revision at 6-month intervals. Lastly, we will compare compliance rates prior to and after implementation of clinical care pathways to determine if integration with the electronic health record and nurse navigation improved compliance.
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