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The kaiser permanente interregional breast care leaders.

Despite advances in detection and treatment of breast cancer in recent years, this disease remains the leading cause of new cancer cases in women in the United States (an estimated 215,990 (32%) of these cases in 2004) and the second leading cause of cancer deaths in US women (an estimated 40,110 (15%) of these cases).1 
 
A multidisciplinary team of clinicians from all Kaiser Permanente (KP) Regions, the Interregional Breast Care Leaders (IRBCL; Table 1), is working to improve programwide quality of care for patients with breast cancer and to reduce mortality from this disease among KP members. The IRBCL is led by The Permanente Federation and includes physicians from KP Departments of Primary Care, Surgery, Oncology, Obstetrics and Gynecology, Radiology, Mammography, Genetics, Women's Services, as well as representatives from various KP Regional Breast Cancer Task Force groups, Clinical Nursing, Quality Resource and Risk Management, Public Relations and Issues Management, Health Education, and Prevention Services. 
 
 
 
Table 1 
 
The Interregional Breast Care Leaders (IRBCL) exemplify the type of multidisciplinary team that can be assembled by a large group practice to design and implement improvement in the quality of clinical care 
 
 
 
Breast cancer leads to the most malpractice claims among misdiagnosed conditions. 
 
The IRBCL is chaired by Jed Weissberg, MD, Associate Executive Director for Quality and Performance Improvement for The Permanente Federation. Other leading participants include Susan Kutner, MD (Department of Surgery, KP San Jose Medical Center), who is also Chair of the Breast Cancer Task Force for the KP Northern California Region; and Joanne Schottinger, MD, a medical oncologist who is Assistant to the Associate Medical Director for Quality and Clinical Analysis for the Southern California Permanente Medical Group. 
 
The IRBCL illustrates how the Permanente Medical Groups increasingly work across KP regional boundaries to improve clinical quality and to enhance KP's reputation as a quality leader. “Most Permanente physicians don't understand what The Permanente Federation does,” Dr Kutner notes. She continues, “The IRBCL is a perfect example of how a national organization can improve the quality of our services and the quality of our physicians' lives as well.” Dr Weissberg agrees, saying, “The IRBCL shows that people can energize and inspire each other around the [KP] Program with their passion for improvement.”