Improving delivery of ambulatory care for cancer patients: experience of the Rapid Assessment Clinic in a tertiary institution — ASN Events

Improving delivery of ambulatory care for cancer patients: experience of the Rapid Assessment Clinic in a tertiary institution (#385)

James Kuo 1 , Madhawa De Silva 1 , Desmond Yip 1 2
  1. Department of Medical Oncology, The Canberra Hospital, Garran, ACT 2605, Australia
  2. ANU Medical School, Australian National University, Canberra, ACT 0200, Australia

Background: It can be challenging for cancer patients to receive timely advice and care in between scheduled treatment or review clinic due to the complexity of their care need. A Rapid Assessment Clinic (RAC) was established in September 2013 at The Canberra Hospital to improve access to care for cancer patients. We evaluated its effectiveness in the delivery of ambulatory care.

Methods: Patients who were receiving chemotherapy and who presented for assessment at the RAC from September 2013 to June 2014 were included for review. Relevant clinical data including patient and tumour characteristics, presenting complaints, time to assessment and total time spent at the RAC, and assessment outcome were extracted. Similar data for cancer patients who presented to the Emergency Department (ED) but would have been appropriate for RAC assessment from February 2012 to August 2012 were reviewed for comparison.

Results: 77 cancer patients presented to ED over the 7-month period; 19 (24.7%) were appropriate for RAC assessment. The median time to review and total time spent for these patients were 127.5 minutes and 495 minutes respectively. 15 patients (78.9%) required hospital admission and had an average length of stay (LOS) of 12.4 days. 217 patients were reviewed at the RAC over the first ten month of its establishment. The majority presented with new symptoms (n=46, 21.2%); 123 patients (56.7%) presented with symptoms unrelated to chemotherapy. These patients had an improved median time to review (28.3 minutes) and total time spent (183 minutes) in comparison to those reviewed in ED. The rate of hospital admission via RAC was 14.3% (n=31) with an average LOS of 6.5 days.

Conclusion: Establishment of RAC had improved delivery of ambulatory care to cancer patients by reducing the waiting time for assessment and rate of hospital admission, despite a high rate of presentations with new or non-chemotherapy related symptoms.

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