To Reduce the Time from Triple Assessment Clinic to Diagnosis and Treatment of Breast Cancer.

The Coronavirus disease (COVID-19) has had a profound impact on healthcare systems and has led to increased waiting times for diagnosis and hospital treatments. Since the emergence of COVID-19 in March 2020, the triple assessment process has experienced changes to its usual flow, leading to delays. This project examined the stages at which these delays occurred and collected data using quality improvement tools to explore these delays. The use of the Lean and Six Sigma tools within a DMAIC framework assisted with discovering these areas and recommended measures to improve this process. This study found that between March and December 2020, 31% (n=15) of patients had all elements of the triple assessment process carried out in one day. This data was compared to pre-COVID-19 data which showed that between March and December 2019, 100% of the patients attending the Triple Assessment Clinic had all elements of the process completed in one day (n=15).Further examination revealed that the majority of delays occurred between the patient’s first appointment, and returning for imaging, with 44% experiencing delays at this stage. The average wait time for surgical intervention between March 2020 and December 2020 was 28 days, in comparison to 19 days during the pre-COVID-19 period. Finally, the data highlighted that 25% of patients (n=20) between March-December 2020 experienced either cancellations, postponed appointments, or completion of assessment over the phone. This project recommends guidelines for prioritisation of patients through the Triple Assessment process and provides guidance notify patients of the changes to the TAC prior to attending their initial appointment.