Patient characteristics and outcomes at the University of Kansas Cancer Urgent Care (CUC).

Abstract

e19154 Background: An increasing proportion of advanced cancer patients live longer and seek urgent or emergent care due to complex treatment regimens. Prolonged wait times and excessive cost of care are common deterrents for these patients to seek care in the Emergency Department (ED). Cancer Urgent Care (CUC) was established in February 2019 with the goal to provide timely and specialized care and improve outcomes for symptomatic cancer patients. Methods: CUC is staffed by two advanced nurse practitioners and two registered nurses and operates from 7am till 7 pm, Monday to Friday. Between 2019-2020, 471 patients were seen at the University of Kansas CUC. Visit information including diagnosis, duration of stay and outcome was retrospectively collected and analyzed using the REDcap database. Patient satisfaction and feedback surveys were conducted for each visit. Results: Most common causes for which patients sought care were dehydration 41.6%, nausea or vomiting 25.9%, pain 16.8%, diarrhea 9.8%, fever 9.6%, fatigue 8%, pneumonia 6.4% and sepsis 2.1%. Nearly 34% patients seen had underlying hematologic malignancy, other common disease sites included gastro-intestinal (26.8%), genito-urinary (14.6%) and breast cancer (13%). Average time to patient evaluation was 17 minutes and patients spend a mean of 3.2 hours in the CUC. Escalation of care (ED transfer) was required in 36 patients (7.6%), a majority of which (n = 28, 78%) required inpatient admission. An additional 58 patients (12.3%) required direct inpatient admission while a majority of patients (n = 385, 79.6%) were discharged home from the CUC. Overall patient satisfaction was very high, 68% patient noted that they would have sought care in ED if they were not seen in CUC while 30% patients would have waited for their next clinic appointment to discuss symptoms. Conclusions: Greater than 90% patients seen in CUC had a diagnosis being evaluated under Chemotherapy Measure (OP-35) by CMS. CUC provides a viable mechanism to provide specialized care to cancer patients resulting in improved patient satisfaction. Additional studies are ongoing to evaluate its impact on ED utilization and cost-effectiveness.