Five Ways to Help Cancer Patients Avoid the Emergency Room
Unnecessary emergency department visits and hospitalizations are debilitating for patients with cancer and far too common - and costly - for
The five strategies are: 1) identify patients at high risk of unplanned acute care; 2) enhance access and care coordination among health professionals; 3) standardize clinical pathways for symptom management; 4) develop urgent cancer care tactics, and 5) employ early palliative care. Researchers published their findings and recommendations this month in the
Unplanned acute care for patients with cancer is a major driver of unnecessary health care utilization and cost in
Handley led this exhaustive review of research, evidence, and quality guidelines on reducing unnecessary ED visits and hospitalizations and an evaluation of selected care delivery models. The research team then categorized and assessed each of the five strategies based on outcomes such as reductions in ED visits, hospitalizations, and rehospitalizations within 30 days, and defined gaps in knowledge for future study.
"These recommendations put the patient at the center of how we give cancer care by leveraging advanced big data analytics, team-based care, alternative care settings, and care pathways," said
Penn Medicine and the
"We've seen excellent results with this approach here at Penn with our Oncology Evaluation Center, an urgent care-type clinic specifically for our cancer patients," said study co-author
Other recommendations are underutilized throughout cancer centers in the
"While patients are hearing more and more that these conversations should happen early, we still see many cases where this doesn't happen until after patients are already in the hospital due to complications that could be devastating," Handley said. "The oncology community would benefit from more robust training and new efforts to initiate palliative care planning earlier in the course treatment."
Schuchter says this training is also already ongoing at Penn.
The researchers also say that because of the large investment required to implement these recommendations, further research and evaluation is needed to identify the optimal strategies for different types of care settings and cancer centers.
"These strategies will improve patients' experience with their cancer care, but they are not only good for patients," Bekelman said. "Health care providers should move in these directions now, especially as new payment models for health and medical care amplify the need for cancer programs to focus on reducing unnecessary emergency department visits and hospitalization."
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