Acute Oncology and Same Day Emergency Care (SDEC)

Title and authors

Presented 

Date added

The acute medical perspective of acute oncology patient presentation

This presentation reviews the pathway of a patient who presented as an emergency and has a supected cancer diagnosis.

(Dr Radha Selvaratnam. Consultant physician – Acute medicine and malignancy of unknown origin (MUO) service lead, Kings college Hospital. Co-Chair Society of Acute Medicine Acute Oncology sub-group.BAAEC – Acute medicine representative)

AEC WEBINAR -  CANCER SDEC

Dr Marshalls presentation highlights the growing need for ambulatory acute care services for patients suffering from acute probelms realting to cancer and/or its treatment and how this can be linked to and developed wiht acute medical services. 

Acute Oncology and Ambulatory Care Pathways Presentation

This presentation focuses on the future AO aim • A&E/Ambulatory focus – seeing patients at the front door • Hot clinics • SDEC – Cancer centre/local • Teamwork • Communication • National data recording

ACUTE ONCOLOGY AMBULATORY PATHWAY POTENTIAL IN ANEURIN BEVAN HEALTH BOARD

Background- Cancer care is an increasing burden on the NHS, the Acute Oncology service at ABUHB currently only has inpatient pathways. There was a need to understand what may affect the length of stay for AOS patients at ABUHB and whether this could be reduced, to improve cost efficiency and patient experience. The objective was to identify if AOS and MUO/CUP patients could be managed by an alternative ambulatory pathway. Using subjective analysis of patient pathways to identify reasons for admission and reasons for any delayed discharge.

CHESHIRE & MERSEYSIDE CANCER ALLIANCE  URGENT CANCER CARE PROGRAMME SAME DAY EMERGENCY CARE (SDEC) PROJECT

Background- A Same Day Emergency Care (SDEC) project has been funded by the Cheshire and Merseyside Urgent & Emergency Care Network as one component of a programme of care focussed on emergency cancer pathways. Three Trusts, Wirral University Teaching Hospital NHS Foundation Trust, Southport & Ormskirk Hospital NHS Trust and St Helens & KnowsleyTeaching Hospitals NHS Trust (WhistonLung), have been identified as SDEC early adopter sites.

Screening for sepsis in cancer – designing and auditing a modified criteria to improve diagnosis

Sepsis is defined as ‘life-threatening organ dysfunction caused by a dysregulated host response to infection.’ It remains a common condition with a high attributable mortality particularly in oncology patients as a result of immunosuppression from malignant infiltration or more commonly neutropenia secondary to chemotherapy. All healthcare professionals have a responsibility to effectively screen for sepsis as rapid recognition and treatment is vital in preventing morbidity and death.

The UK sepsis trust screening tool is widely used and endorsed by NICE(1). This promotes a red and amber flag system of signs and symptoms which supports clinical decision making in diagnosing sepsis.

At Clatterbridge Cancer Centre (CCC), approximately 50% of patents attending the acute oncology Clinical Decisions Unit (CDU) have received cytotoxic chemotherapy within the 6 weeks prior to presentation. This will automatically signal a red flag on the UK sepsis trust screening tool and limit the utility of the sepsis screen. There is clinical need for a more specific sepsis screening tool in oncology patients to differentiate sepsis from other presentations such as cancer progression, without compromising on sensitivity.

    The Acute Oncology HOT Clinic (AOHC)    The LancashireTeaching hospitals NHS Foundation Trust

Aim: The aim of the AOHC is to provide oncology patients who are receiving SACT the opportunity to be assessed, treated and discharged with appropriate follow up.

This will result in:

• Improved patient experience
• Early specialist input
• Admission avoidance
• Reduced demand on GP and AMA

   SDEC for Acute Oncology in Nottingham University Hospitals

Cancer Associated Triage Team CATT 24hr phoneline triage team for all oncology patients on active treatment based on UKONS guidance. Triaged to:

• Over the phone advice

• Await clinic review

• GP or ED service support

• SDEC for review <24hrs

• Specialist Receiving Unit (SRU) for direct admission (24hr admission unit)

• Lister 1 ward for semi-elective work eg transfusions or electrolyte replacement SDEC triages: Ambulatory patients with an acute problem that requires same day or next day review.

Cancer patients admission in a medical ambulatory emergency care unit - Surrey and Sussex Healthcare NHS trust

Aim:Patients with cancer often require emergency hospital care to manage their acute medical needs. Limited data is available on how cancer patients present to medical ambulatory emergency care service. The aim of the study is to identify the characteristics, presentation and the need of cancer service in the unit.