QIM20-130: An Immediate Care Center for Oncology Patients “Symptom Management Doesn’t Require the Emergency Department”

Background: The James Comprehensive Cancer Center experiences continued growth. Outpatient clinics have an avg. of 22,000 exam visits and 7,000 infusion visits monthly. Outpatient oncology patients have increased complexity as care transitions from the inpatient arena. Symptom management, complications of therapy and progression of disease are a significant consideration. Historically patients seeking symptom management were seen as an unplanned visit in outpatient clinics. Busy clinics create a sub-optimal experience. If unable to be seen in outpatient clinics, patients were directed to the emergency department (ED) causing dissatisfaction with wait time and frequent admission out of the ED. To provide timely and focused care the need for an alternative care location was recognized. Methods: The Immediate Care Center (ICC), an outpatient unit was opened in April 2018. The intent of the ICC is to manage acute unexpected symptoms that do not meet the criteria of an emergent visit but require evaluation and treatment. The ICC opened M -F; 7am – 11 pm quickly expanding to weekends and holidays and transitioning to a 24/7 operation in November 2018. Patients are referred to the ICC by their primary team or telephone triage nurses. Advanced practice providers evaluate and establish a treatment plan which may include diagnostic evaluation, intravenous fluids, antibiotics, anti-emetics, pain management, and transfusion of blood products and wound management. Results: Patient volume in the ICC has tripled since opening, avg. 300 patient visits/month. Press Ganey overall patient experience scores for fiscal year 2019 = 97th percentile. Patients are often able to receive treatment and be discharged home with a small percentage being admitted. (See Graph) Conclusion: Oncology patients require specialized care that is a challenge in a rapid paced ED. The necessity to manage symptoms associated with cancer in an ED is not patient centered. ED visits are more likely to result in an unplanned hospital admission; increasing the cost of health care and placing patients at risk for further complications throughout their hospital stay. Based on patient experience, need and physician feedback plans to expand the current ICC to double capacity are underway.

If the inline PDF is not rendering correctly, you can download the PDF file here.

Corresponding Author: Penny Moore, MSN
All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 63 63 3
PDF Downloads 112 112 0
EPUB Downloads 0 0 0