Many hospital and freestanding breast disease programs around the country are scurrying to qualify for the National Accreditation Program for Breast Centers, a new survey validation that began Jan. 1.
So far, says David P. Winchester, MD, chairman of the program's board, only 125 hospitals nationally in 30 states have been accredited, but another 150 are in the last stages of the application process, which is administered by the American College of Surgeons. About 1,200 have sent inquiries.
The effort to develop an accreditation program for breast disease care began because, with 250,000 patients diagnosed annually with breast disease—190,000 with invasive and 60,000 with non-invasive disease—"there is such a major public health problem, and there has been a proliferation of 'breast centers' around the country in the last decade" Winchester says. Yet there was no organization or effort to establish evidence-based care criteria, visit the centers, and give guidance for improving quality, he says.
"Here we are with an unknown number of breast cancer centers in the country, probably about 1,500, yet nobody could answer the question about whether there is a problem with quality," Winchester says. No one knew which centers embraced "widely accepted evidence-based standards," and which ones perhaps fell short.
"The old system was very fragmented, involved several individuals offering their own opinions of different types of care, even in our own geographic area," says William Dugoni , MD, medical director of Washington Hospital's women's health program, the latest to receive accreditation. "What we've done is standardize and we've given patients opportunities to have equal access, and to have their cases discussed by a multidisciplinary team."
The only other accreditation agency that looks at cancer care quality, Winchester says, is the Commission on Cancer, an 80-year-old program that reviews 36 standards for cancer care, but doesn't focus on or specialize in any one. It certainly does not look at breast care with nearly the detail, says Winchester, who also is the Commission on Cancer's medical director.