Authors: (including presenting author): :
Wong L, Lau YC, Cheung BBH, Suen TKD, Kwong A
Affiliation: :
Department of Surgery, Queen Mary Hospital and Tung Wah Hospital
Keyword 1: :
This nurse-led model
Keyword 2: :
a pre-SOPC triage nurse-led model
Introduction: :
Patients presenting to the Accident and Emergency Department (AED) with suspected or confirmed breast malignancy often experience significant distress and are at risk of unnecessary hospital admission due to the absence of a structured care pathway. To address this, a nurse-led coordination model via telephone counselling by Breast Care Nurses (BCNs) was implemented in Department of Surgery of Queen Mary Hospital. This initiative aims to improve early communication, triage, and psychosocial support before patients attend the Specialist Outpatient Clinic (SOPC).
Objectives: :
To reduce avoidable hospital admissions, streamline diagnostic and treatment pathways, and enhance emotional support and service efficiency for patients with suspected or confirmed breast cancer presenting via the AED.
Methodology: :
Since 2020, BCNs have proactively contacted patients referred from the AED (via fax initially, then electronic referral from 2023 onwards). The BCN role involves clarifying clinical findings, explaining breast cancer diagnostic pathway (triple assessment), coordinating imaging and SOPC appointments based on triage guidelines, and providing psychological support. From the third quarter of 2025, an informational pamphlet incorporating QR codes was introduced to provide details on the breast cancer diagnostic process, Hospital Authority (HA) Go mobile applications, and private imaging options, with the dual aims of improving patient information access and reducing BCN telephone consultation time. Data from the electronic referral period (January 2023 to December 2025) were analysed.
Result & Outcome: :
Results From 2023 to 2025, 226 patients were referred, with annual volumes rising from 53 to 94. Malignancy was confirmed in 31 cases (13.7% of total). Among these cancer patients, 29% (n=9) chose private surgery and 6.5% (n=2) were referred directly to oncology. Of the 195 suspected cases, 36% (n=70) undertook private imaging before their first specialist clinic visit after the BCN consultation, refining the triage process. The introduction of the QR code information pamphlet reduced the average BCN consultation time by 20% (from 25 to 20 minutes). A December 2025 survey confirmed high patient satisfaction with the service. Conclusion This nurse-led model demonstrates that early engagement and structured triage by BCNs for patients with suspected or confirmed breast malignancy via the AED can enhance care efficiency, reduce unnecessary admissions, and improve psychological support. The model underscores the central role of BCNs in advancing key healthcare initiatives, including the Hong Kong Government Cancer Strategy and Smart Hospital projects, by providing timely, compassionate, and cost-effective nursing care. A proposed future development is the establishment of a pre-SOPC triage nurse clinic to further optimize timely care prior to a definitive breast cancer diagnosis.
