The expansion of infusion services to a weekend-inclusive, 7-day per week model led to a lower number of emergency department (ED) visits, saved inpatient days, and reduced hospital length of stay for oncology patients. This data was presented by Marie Iannelli Carrera, CRNP, Nurse Practitioner, University of Pennsylvania, at the Journal of the Advanced Practitioner in Oncology (JADPRO) meeting in Grapevine, Texas.

“Health care systems are obligated to provide patients with the right care, in the right place, at the right time,” explained Carrera and colleagues, “It is a priority within oncology to reduce the amount of time patients spend dealing with their cancer, a concept known as time toxicity.”

The Oncology Evaluation Center (OEC), an Advanced Practice Provider (APP) service, had been offering same-day symptom management to patients at 5 days per week since 2016. In order to address these patient care needs, a multidisciplinary group committee from inpatient and ambulatory settings came together to expand these OEC services to a weekend-inclusive model of 8 hours per day beginning in March 2024. The services offered were chemotherapy administration, transfusion, supportive care, and symptom management evaluation. 

To track data, they utilized a lean six sigma methodology including plan-do-study-act cycles, retrospective chart reviews, monitoring through a validated hospital dashboard, and meeting weekly to validate and refine the data collection process. 

Over 18 weekends of operation ending in June 2024, the data showed that this method saved 611 annualized inpatient days through their allowance of patients with high transfusion needs to be discharged earlier. In addition, they prevented 464 annualized ED visits, adding to an estimated 1392 additional inpatient days saved based on their estimation that 33% of oncology patients who present to the ED are subsequently admitted. These adjustments reduced the observed to expected length-of-stay from 1.10 to .99. They turned away 13 patients due to necessity after reaching capacity. 

“The reductions we have achieved in ED utilization and inpatient bed-days mean better access to ED and inpatient facilities for all patients whenever they truly need them,” concluded Carrera and coauthors. “Based on the early successes of this model, weekend services will be extended to 12-hours per day.”

“Future development will include 24-hour OEC services, 7 days a week,” they added. 

Source:

Carrera M, McGettigan S, Kucharczuk C, et al. Weekend Infusion Services for Oncology Patients Save Inpatient Days and Emergency Department Visits. Presented at the 2024 Journal of the Advanced Practitioner in Oncology Meeting. November 14-17, 2024; Grapevine, Texas.