The University of California San Francisco (UCSF) Breast Care Center (BCC) is a high volume specialty clinic providing multi-disciplinary care in a National Cancer Institute-designated Comprehensive Cancer Center. Eight medical oncologists and four surgeons, among dozens of specialists, providers and staff, conduct more than 1,000 consultations annually, caring for more than 600 newly diagnosed patients each year.
The Decision Services Unit of the Breast Care Center at UCSF became a Foundation-funded specialty care demonstration site in 2005 in order to offer their patients a unique type of decision support and guidance along their journey.
Listen to Dr. Alvarado discuss the benefits of patients using decision support tools.
Current Shared Decision Making Activities
Since 2005, the UCSF BCC Decision Services Unit has routinely provided decision aids (DAs) and comprehensive decision support to breast cancer patients prior to consultations. Providers at BCC use the Foundation’s breast cancer suite of decision aids (Shared Decision-Making® programs).
An Innovative Model for Shared Decision Making
In the BCC’s unique implementation model, pre-medical interns working for Decision Services contact breast cancer patients and assist them with creating a list of questions and concerns, accompany patients as they navigate clinic resources, and take notes during consultations, as well as audio record discussions with providers. These services support informed and shared decision making by ensuring that patients are able to access and review critical information necessary for making a truly informed decision about cancer treatment. The pre-medical interns in the program are recent college graduates working as research or project assistants throughout UCSF for a year or two before going on to further training in health-related professions. These interns gain the experience of interacting with patients in a supportive capacity and gain valuable knowledge that will serve them well in their future careers in health care.
Decision support is truly becoming a routine part of the BCC, with ever increasing involvement from providers and support staff. The pre-medical intern team manages distribution of decision aids, the provision of one-on-one decision support and the collection of data from patients, as well as providing valuable observations and insights into shared decision making practices in the clinic. As a way of growing and testing what the BCC team has learned in the clinic and in other areas, the team has launched the Patient Support Corps as a virtual network of organizations deploying students, trainees and volunteers as patient advocates who deliver decision support. Charter members include UCSF and Dartmouth.