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A Standardized Education Class To Increase Efficiency And Access To Breast Reconstruction
Dominic Henn, MD, Arash Momeni, MD.
Stanford Universty, Stanford, CA, USA.

PURPOSE:
Shared decision-making is a key component of patient-centered care and has been shown to improve patient satisfaction and quality of life. Strategies to improve access to breast reconstruction while maintaining high quality standards of patient education, fostering shared decision-making, have not been established in Plastic Surgery so far.
METHODS:
Since January 2019 a 1-hour standardized patient education class was offered to all new patients in addition to standard consultations in the breast reconstruction clinic of the senior author. The number of new patient consultations per clinic day over a period of 6 months and the average consultation time after introduction of the patient education class were compared to the number of new consultations and the consultation time before introduction of the class. To evaluate the patientsí perception of shared decision-making, the 9-item Shared Decision Making Questionnaire(SDM-Q9) and the Satisfaction with Informationscale of the BREAST-Q Reconstruction Module were electronically distributed among the patients and compared between the two groups (n=30 for class participants, n = 20 for non-participants).
RESULTS:
After introduction of the patient education class, the average duration of new patient encounters was significantly shorter compared to the period before the class was introduced (31.8 min vs. 53.5 min, p < 0.01). Accordingly, the rate of new patient consultations increased by 43.5% from 4.6 to 6.6/clinic day after introduction of the class. No significant differences were seen between class participants and non-participants in the SDM-Q9 scores (average sum score: 96 vs. 91, p = 0.58) and BREAST-Q scores (74 vs. 85, p = 0.14), indicating a non-inferiority of the education class in terms of patient education and autonomy compared to traditional consultations.
CONCLUSION: By introducing a standardized patient education class to our breast reconstruction clinic, we were able to significantly shorten the average duration of new patient encounters, thereby increasing access for patients to breast reconstruction, while at the same time maintaining a high standard of patient education and perceived shared decision-making among patients.


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