A breast clinic co-located in a radiology department and staffed by an advanced registered nurse practitioner enables prompt evaluation and diagnosis of patients with breast symptoms, leading to lower utilization and costs, increased efficiency for breast surgeons, and high levels of patient satisfaction.
Multiple pieces of legislation in Washington state are starting to have an impact on use of shared decisionmaking in clinical practice, including a mandated demonstration project, recognition of use of decision aids as informed consent in malpractice cases, and formation of a learning collaborative.
An Arizona clinic for women refugees provides comprehensive, culturally sensitive care across the reproductive life span, leading to enhanced access to services, high patient satisfaction, greater awareness of breast cancer and mammography, and better planning for childbirth.
Verizon adopted a policy related to selecting vendors that emphasizes the ability to identify and address health disparities, leading to enhanced access to information and screening services for racial and ethnic minority employees, dependents, and retirees.
The Daylight program uses trained volunteers—recognized and influential women from local refugee and immigrant communities—to provide to their peers culturally sensitive information about breast health and breast cancer, including early detection methods.
Decision aids and one-on-one counseling sessions help newly diagnosed breast cancer patients evaluate their treatment options and preferences before the initial surgeon visit, leading to high levels of patient satisfaction and knowledge, less conflict about and greater comfort with decisions made, many changes in treatment preferences, and better patient–surgeon interactions.
A monthly clinic provides culturally competent cancer screening and educational information to rural, low-income Hispanic women over the age of 40 years, leading to enhanced access to such screenings and to increased use of primary care.
A pathologist and radiologists jointly review diagnostic test findings and develop care plans, leading to improved care of patients being screened for breast cancer.
A community partnership developed culturally appropriate outreach and education, leading to enhanced access to breast cancer screening and earlier detection of the disease in African-American and Hispanic women.
Targeted educational initiatives, including videos on cancer education and a fellowship program on American Sign Language and the deaf culture, increase the knowledge of patients who are deaf or hard of hearing, and improve the cultural competency of providers.