RESUMO
A performance improvement team overhauled its facility's rehabilitation systems. A rehabilitation care plan was revised and an integrated assessment reduced 29 pages of documentation to 17 pages. Case management goals and documentation are integrated into one care plan.
Assuntos
Reabilitação/organização & administração , Simplificação do Trabalho , Participação da Comunidade , Humanos , Inovação Organizacional , Objetivos Organizacionais , Análise e Desempenho de TarefasRESUMO
Twenty-eight patients with inflammatory carcinoma of the breast have been retrospectively reviewed. Overall 5 year survival was 25 percent. There was a trend toward improved survival in patients who received chemotherapy which did not achieve statistical significance. Sixteen patients underwent mastectomy as part of their treatment. These patients had a 48 percent 5 year survival which was significantly better than the survival in patients who did not undergo mastectomy. Furthermore, mastectomy resulted in better control of the local disease. Of 12 patients who did not undergo mastectomy, local control was initially obtained in only 2, and both of these patients suffered local recurrence within 1 year. Our data support the conclusion that mastectomy be combined with preoperative and postoperative multiagent cytotoxic chemotherapy in the treatment of inflammatory carcinoma of the breast. More precise staging may permit better prognostic stratification of patients with this highly malignant cancer.