Optimal utilization of a breast care advanced practice clinician

Katie W. Russell, Mary C. Mone, Victoria J. Serpico, Cori Ward, Joanna Lynch, Leigh A. Neumayer, Edward W. Nelson

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Background Incorporation of "lean" business philosophy within health care has the goal of adding value by reducing cost and improving quality. Applying these principles to the role of Advance Practice Clinicians (APCs) is relevant because they have become essential members of the healthcare team.

Methods An independent surgical breast care clinic directed by an APC was created with measurements of success to include the following: time to obtain an appointment, financial viability, and patient/APC/MD satisfaction.

Results During the study period, there was a trend toward a decreased median time to obtain an appointment. Monthly APC charges increased from $388 to $30,800. The mean provider satisfaction score by Press Ganey was 96% for the APC and 95.8% for the surgeon. Both clinicians expressed significant satisfaction with clinic development.

Conclusions Overall, initiation of an APC breast clinic met the proposed goals of success. The use of lean philosophy demonstrates that implementation of change can result in added value in patient care.

Original languageEnglish (US)
Pages (from-to)1054-1059
Number of pages6
JournalAmerican journal of surgery
Issue number6
StatePublished - Dec 1 2014


  • Advanced practice clinician
  • Improved utilization
  • Independent breast care clinic
  • Lean principles
  • Nurse practitioner
  • Physician assistant

ASJC Scopus subject areas

  • Surgery


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