Loreen Herwaldt, MD, will lead a team of researchers in a collaborative study funded through a Holden Comprehensive Cancer Center (HCCC) pilot grant. The team will audit the patient experience during the breast cancer diagnostic period, from the initial screening mammogram through initial treatment following a positive diagnosis, whether treatment is surgery or chemotherapy. In addition to examining the diagnostic period in its current operational state, the study aims to identify interventions that will improve the patients’ experiences during this difficult period, which may be tested in future studies.

This is an extension of a pilot study that observed the same set of data; for this phase, the group will be increasing the number of observed patients. “We will conduct in-depth, semi-structured interviews with 15 patients who recently began breast cancer treatment at the UIHC,” Herwaldt said. “We will revise our prior interview guide to elicit the patients’ suggestions for potential interventions that could improve their experiences, and ask them to describe their perceptions of the most significant steps or moments during the diagnostic period.”

The pilot study interview includes an overview of the patients’ diagnostic period experiences, including their thoughts and feelings about the decision-making process and barriers encountered through the process, as well as encounters with the different specialties a patient encounters in this timeline. The interview also covers how these encounters affected them throughout this time period.

From there, the team will identify themes from the participants to help identify actionable interventions at the individual provider, provider team, and organizational level. Possible solutions to improve the patient experience will be presented to the HCCC leadership team, with the goal of developing an action plan to put the group’s findings into practice.

Herwaldt’s research group includes breast surgeons from the Department of Surgical Oncology and Endocrine Surgery Ingrid Lizzaraga, MBBS, FACS (Clinical Professor of Surgery); Sonia Sugg, MD (Clinical Professor of Surgery); and Lillian Erdahl, MD, FACS (Clinical Associate Professor of Surgery). They will identify participants for the study and guide the team on interview revisions as data is analyzed. DeShauna Jones, PhD (Research Analyst, University of Iowa Institute for Clinical and Translational Science), will conduct interviews and oversee a research assistant who will manage ethnographic coding and analysis. Jones will work with Herwaldt on the majority of the study’s aspects.