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Nurse-led emergency department avoidance model of care for patients receiving cancer therapy in the ambulatory setting: a health service improvement initiative. |
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| Subject |
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Emergency department avoidance |
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#PLACEHOLDER_PARENT_METADATA_VALUE# |
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#PLACEHOLDER_PARENT_METADATA_VALUE# |
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#PLACEHOLDER_PARENT_METADATA_VALUE# |
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#PLACEHOLDER_PARENT_METADATA_VALUE# |
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#PLACEHOLDER_PARENT_METADATA_VALUE# |
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#PLACEHOLDER_PARENT_METADATA_VALUE# |
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| DOI |
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10.1186/s12913-023-09693-0 |
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| Abstract |
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The Symptom and Urgent Review Clinic was a service improvement initiative, which consisted of the implementation and evaluation of a nurse-led emergency department (ED) avoidance model of care. The clinic was developed for patients experiencing symptoms associated with systemic anti-cancer therapy in ambulatory cancer settings. The clinic was implemented in four health services in Melbourne, Australia across a six-month period in 2018. Evaluation was by prospective data collection of the frequency and characteristics of patients who used the service, pre- and post-survey of patient reported experience, and a post-implementation survey of clinician engagement and experience. There were 3095 patient encounters in the six-month implementation period; 136 patients were directly admitted to inpatient healthcare services after clinic utilization. Of patients who contacted SURC (n = 2174), a quarter (n = 553) stated they would have otherwise presented to the emergency department and 51% (n = 1108) reported they would have otherwise called the Day Oncology Unit. After implementation, more patients reported having a dedicated point of contact (OR 14.3; 95% CI 5.8-37.7) and ease of contacting the nurse (OR 5.5; 95% CI 2.6-12.1). Clinician reported experience and engagement with the clinic was highly favorable. The nurse-led emergency department avoidance model of care addressed a gap in service delivery, while optimizing service utilization by reducing ED presentations. Patients reported improved levels of satisfaction with ease of access to a dedicated nurse and advice provided. |
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| Citation |
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BMC Health Services Research 2023-06-29; 23(1) |
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BMC Health Services Research |
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