ORLANDO, FL—A retrospective descriptive study has found that patients with cancer require frequent emergency department (ED) visits, so much so that the James Cancer Hospital in Columbus, Ohio, has decided to launch the first fully integrated oncology ED in the United States, according to a presentation at the ONS 40th Annual Congress.
During fiscal year 2014, the hospital had 11,262 admissions and 336,695 outpatient visits. An average of 700 patients with cancer sought emergency medical attention at the university’s ED monthly.
“While the patients were well managed, one might wonder if their treatment or outcomes would differ if the care they received was delivered by specialized, multidisciplinary clinicians with hematology and oncology training,” asked Miranda Gill, MSN, RN, of The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute in Columbus.
“Would it be significant enough to warrant an oncology emergency department?” she added.
The study used a quantitative analysis that included reviews of electronic hospital records on patients with an oncology diagnosis who presented to the ED seeking emergency care.
“The review was relevant in assessing and projecting volume as well as trending peak arrival day of week and time, arrival mode, acuity, and presenting diagnosis,” Gill noted. “Top diagnoses included leukemia, lung, breast, and gastrointestinal cancers. Volume was highest on Mondays, and between the hours of 1200 and 1600.”
The study found that patients with cancer require frequent ED visits. However, what remains to be determined is whether treating patients in an oncology-specific ED “will affect outcomes such as admissions, length of stay, infection rates, and satisfaction.”
Nearly 14 million Americans are either living with cancer, or are survivors, with an estimated 1.6 million new cases diagnosed in 2014, according to the American Cancer Society. While breakthroughs in treatment are related to increased survival, “conditions resulting from metabolic, neurologic, cardiovascular, hematologic changes caused by malignancy or its treatment require immediate intervention,” she stated.
Noting a lack of literature on this topic, Gill said she and her colleagues “look forward to collaborating with emergency medicine and oncology professionals to create exceptional outcomes for our patients.”
She added, “We foresee great opportunity in creating a subspecialty within the practice of oncology nursing, and know it will benefit patients, families, and clinicians.”