Building a Breast Center:

The Clinical Breast Care Project Experience

Authors:  Craig D. Shriver MD FACS; Arthur W. Hapner; Nancy Opsahl, RN

Location Address:  Comprehensive Breast Center, Walter Reed Army Medical Center, Bldg.2, Ward 55, Washington, DC 20307-5001

Designated Authors:  Arthur W. Hapner; arthur.hapner@na.amedd.army.mil      

Introduction:  The Walter Reed Army Medical Center Comprehensive Breast Center stemmed from the vision of Dr. Craig D. Shriver.  The vision was to build a center where patients were the focus of the effort verses the physician and that was truly “transitional” i.e. bringing the scientific research and clinical care together as well.  The challenge was to complete the task in less than a year.  This center is part of a larger project (Clinical Breast Care Project), which encompasses five pillars: Clinical Care, Risk Reduction, Focused Research, Tissue Banking, and Bio-Informatics.

Methods:  The initial planning began in early August 2000 with a projected date of opening of July 2001.  The key to realizing the vision was the forming of the Patient Advocacy Group (Breast Cancer Survivors).  This group provided guidance throughout the planning and execution phase of the project.  Many of the concepts noted by this group were incorporated into the design, which enhanced patient comfort and flow of the center.  The staffing for the facility centered on the term “comprehensive”.  It represents a mix of all functional areas in treatment of breast disease and research oriented professionals.  The key was to bring the service to the patient, rather than have the patient go to the service.

Results:  The Grand Opening of the WRAMC Comprehensive Breast Center took place on July 31, 2001.  Patient Care Services began the following day, which included out patient clinical care and ambulatory (breast) surgical procedures.  For the following few months, effort focused on improving the administrative processes relating to the five pillars of the CBCP and enhancing patient care.  Standard operating procedures were developed, additional staffing hired, access to care for patients was facilitated and patient satisfaction enhanced.  Additionally, the research protocols were implemented and plans began to look a providing public relations and patient services.

Conclusions:  In only 12 months the vision of providing comprehensive breast care and translational research in one place became a reality.  Now all the elements are in place, efforts are being directed towards process improvement of all facets of patient care in the Breast Center.  With appropriate personnel and resources, vision can become reality in a short span of time.