Patients or persons who have undergone breast reconstruction are at times ill prepared for the surgical experience, which results in excess phone calls, unnecessary office visits and anxiety for the patient and his or her caregiver. In 2010, nearly 1.5 million people were diagnosed with breast cancer worldwide. According to the American Cancer Society, an estimated 230,480 new cases of invasive breast cancer were expected to be diagnosed in women in the United States along with 57,650 new cases of non-invasive breast cancer. In California, Marin County has the highest breast cancer rate. California counties with the lowest rates include Imperial and the combined rates for Lassen, Modoc and Plumas. A six step framework developed by June H. Larrabee guided the development of the Capstone system change. Merle Mishel’s Uncertainty in Illness Theory provided the theoretical perspective for guiding this capstone project. Research shows post mastectomy reconstruction has been shown to provide substantial psychosocial benefits for women who undergo mastectomy for the treatment of breast cancer. Despite this, it remains the minority of breast cancer patients undergoing mastectomy who elect tot pursue breast reconstructive options. Authors have identified considerable dissatisfaction with doctors’ lack of attention to patient education. In addition, a correlation has been established between inadequate preparatory information and dissatisfaction following post mastectomy reconstruction. A solution for the unprepared surgical patient is through an evidence-based system change implementing an education program where providers are trained to better prepare patients prior to undergoing breast reconstructive surgery. The capstone system change took place at a National Cancer Center located in Northern California. The capstone system change involved the evaluation of implementing an education program for providers to better educate the breast reconstructive patient. Providers wer educated over a one week period. For one month, clinicians provided both verbal and written instructions to the breast reconstructive patient for preoperative, hospital and postoperative care. In addition, patients received a phone call within the week prior to surgery to answer any last minute questions the patient or family may have had. The intended goal was to reduce the number of postoperative phone calls, and better prepare the patient and family regarding breast reconstructive surgery. Incorporating a system change to better educate the patient who had breast reconstruction is necessary to improve patient satisfaction with the overall surgical experience. For this capstone system change, provider education resulted in a better prepared breast reconstructive surgical patient.
