Abstract PS5-11-29: Implementation of a Rapid Access Referral Program for Breast Cancer: A Quality Improvement Project

Abstract Background: Timely access to cancer care is a barrier to many newly diagnosed breast cancer patients, and treatment delays may negatively affect outcomes. This quality improvement project aimed to reduce time from referral to initial provider visit to 72 hours through the implementation of a Rapid Access (RA) Program. Methods: A multidisciplinary working group utilized Lean methodology to develop a RA process map. Referrals for newly diagnosed stage I-III breast cancer as well as high risk breast lesions were considered RA-eligible. Other types of new referrals (e.g metastatic disease, transfer of care) were RA-excluded for the initial roll-out. A dedicated referral nurse navigator (RA NN) had first contact with patients. Surgical oncology advanced practice providers (RA APP) conducted RA intake visits, with subsequent multi-disciplinary consultation. The following metrics were assessed at pre-intervention baseline and analyzed on a monthly basis after the implementation of the RA program in January 2024: navigation time (time from referral to RA NN phone call), turnaround time (time from referral to scheduling RA APP visit), schedule to service (time from scheduling to RA APP visit), and cycle time (time from referral to RA APP visit). Results: The pre-intervention referral turnaround time, schedule to service, and cycle time was 2.9, 11.7, and 14.5 days, respectively for all new breast referrals. Pre-intervention baseline data was collected from July-June 2023. The intervention evaluation period spanned January-December 2024. Table 1 shows the post intervention metrics at the 1-month and 6 through 12-month timepoints for the RA-eligible cohort as well as post intervention metrics for the RA-ineligible cohort along with the percentage change from pre-intervention. The navigation time, turnaround time, schedule to service, and cycle time at 1 month was .5, .7, 2.0 and 2.70 days respectively. Each of the reported metrics showed sustained improvements at the 6 through 12-month time periods except navigation time. RA-ineligible patients saw worsening in turnaround time and cycle time. Conclusion: Participants in the RA program had improved access to timely oncologic care that was durable over the study period compared to pre-intervention programmatic baseline; however, timeliness of care for RA-excluded new referrals lengthened over the same period. Whether resource concentration on RA patients, or other temporal factors such as workforce changes or increased referral volume, were the drivers of decline in timeliness for RA-excluded patients will be further evaluated. Expansion of RA to a wider variety of referral types, is a potential solution to extend RA benefits. Citation Format: D. Johnson, J. Thomason, J. Vionito, S. Javvaji, K. Reeder-Hayes, J. Aldrich, . Implementation of a Rapid Access Referral Program for Breast Cancer: A Quality Improvement Project abstract. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS5-11-29.