Integrated Care Model Emerges for Oncologic Emergencies

The treatment of cancer is complex, and what might seem like a relatively minor medical issue at first can quickly escalate into an emergency.

In September, The Ohio State University Comprehensive Cancer Center, collaborating with the Department of Emergency Medicine, opened a fully integrated cancer emergency department at the new James Cancer Hospital to care for patients who develop emergencies caused by their cancers.

Oncologic emergencies include pulmonary embolisms, treatment-associated infections, tumor lysis syndrome, surgical problems such as bowel or kidney obstruction, or pain and weakness due to brain tumors or spine metastases. With growing numbers of patients and survivors, the demand for such services will only expand in the coming years, highlighting the need for care teams to be well-equipped to recognize oncologic emergencies and deploy the right interventions.

To gain insight into these matters, OncologyLive interviewed Thomas E. Terndrup, MD, chair of the Department of Emergency Medicine at The Ohio State University Wexner Medical Center.

What is the cancer emergency department? Why is such a department important?

The James Emergency Department is a 15-bed unit on the first floor of our cancer critical care tower at the James Cancer Hospital. Cancer patients need specialized, individualized care.

We want to provide that throughout the James Cancer Hospital, including the emergency service interval. We aim to gather all the individuals who provide care to our patients, so that they have a common understanding of our collaborative approach in these challenges. We also aim to protect patients from infectious diseases.

What are some of the processes in place to expedite the cancer treatment process?

Before a cancer patient actually arrives in the emergency department, our oncologists and practitioners can electronically transmit a notification that a patient is arriving. This notification allows us to be better prepared when the patient arrives, understanding the expectations of the emergency encounter, and expedite his or her care.

What changes are on the horizon?

We want to continuously improve. Our goal is to learn from the experiences of yesterday and to incorporate those findings into even better care and treatment for our patients with cancer.

In a learning organization, that’s what you do every day. For example, we feel that emergency patients would be more comfortable in lounge chairs as opposed to on stretchers. Stretchers aren’t built for comfort, they are built for mobility. When we have an appropriate patient, eg. someone who needs an infusion for a few hours, we can use a modified lounge chair. What is the cost of these emergency services for insurance providers?

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