Document Type
Article
Abstract
Background: Breast imaging depends on single-use, vendor-proprietary consumables produced by a concentrated set of manufacturers. During supply shortages in 2026, healthcare organizations faced urgent pressure to shift from reactive to proactive inventory management. Stereotactic breast biopsy needle shortages revealed that traditional forecasting based on procedure volume lacks the granularity needed for device-specific demand. We aimed to enable device-level forecasting through standardized preprocedure protocolling.
Methods: In a retrospective analysis of 1,456 stereotactic biopsies across 4 breast imaging sites (June 2025 to June 2026), compliance with a standardized electronic protocolling tool that captured lesion count and needle size (standard vs. petite) was assessed. Compliance rates across sites were compared using chi-square analysis, monthly trends were tracked using run charts, and root cause analysis was conducted to identify barriers at the lowest performing site. Epic reports operationalized protocolled data into historical use tracking and 30-day forward demand forecasts.
Results: The overall protocolling compliance rate was 62.7% (913 of 1,456 cases), with striking variation across sites. Specifically, sites A-C achieved 97.3-99.2% compliance, whereas site D (the highest volume site, with 57 cases per month) achieved only 23.4% compliance (c² = 865.7, p < 0.001). Site D remained the lowest performer in all 12 months, indicating systematic workflow failures rather than random variation. Among 913 protocolled cases, the needle mix was 897 standard and 68 petite. Protocolling enabled advance device-demand visibility for about 98% of volume at compliant sites versus only about 23% at site D.
Conclusions: Routine preprocedure protocolling converts radiologist planning into structured demand data that can be queried, enabling proactive device-level forecasting that is invisible to traditional case-count methods. This capability directly supports supply chain resilience during shortages. The practice will sustain improvements through monthly compliance monitoring and rolling 30-day demand forecasts. The next improvement cycle will address root causes of protocolling gaps at the noncompliant site and evaluate mandatory protocolling fields to prevent missed protocols.
DOI
https://doi.org/10.52519/ACEQI.26.2.2.a10
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.
Recommended Citation
Kalambo M, Everding M, Montemayor M, Patel F, Nath M. Standardized Preprocedure Protocolling of Stereotactic Breast Biopsies Enables Device-Level Supply Chain Forecasting: A Multisite Quality Improvement Analysis. Advances in Cancer Education and Quality Improvement. 2026; 2(2). doi: https://doi.org/10.52519/ACEQI.26.2.2.a10.
