Date of Graduation

Spring 5-17-2018

Document Type

Project/Capstone

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

First Advisor

Elena Capella

Second Advisor

Susan Mortell

Abstract

Abstract

In a rural Northern California setting, a Clinical Nurse Leader intern was implemented as a designated Nurse Navigator (NN) for a regional breast health population. The global aim of this project is to improve care for potential and actual newly diagnosed breast cancer patients by increasing access to care, decreasing barriers, and improving timeliness of care. Using evidence based on an extensive scholarly literature review, the designated NN will accomplish the aim through care coordination, thereby improving patient outcomes, decreasing outmigration of care, and increasing the financial viability of the breast health program. The ultimate goal of the breast health team is to obtain accreditation as a Breast Center of Excellence (BCoE) by the National Accreditation Program for Breast Centers (NAPBC). The NN first observed the microsystem and performed an RCA and SWOT analysis. Theory U and the IHI MFI are used to guide the implementation of the project. An existing software program, the Mammography Reporting System (MRS), was utilized to collect specific quality metrics for baseline data, and will be used to evaluate expected improvements. In comparison to the Oncology Roundtable Cancer Quality Metric Selection Tool, targeted metrics to improve include: Time from screening to diagnostics, diagnostics to biopsy, biopsy to surgery, as well as needle core biopsy rate, and outmigration of care. More time is needed to mature data for a viable evaluation of this project, although preliminary feedback has been positive from patients and providers.

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