The timely management of patients’ symptoms is of paramount importance in cancer care. The literature has shown time and time again that proper symptom management not only prevents progression of symptom severity, but results in improved patient satisfaction, quality of life and most importantly, increased survival.
Despite there being several practices in place to support appropriate symptom management, studies done by the Rossy Cancer Network found that approximately 50% of cancer patients across the network still experienced symptoms severe enough to result in hospitalization within 30 days of chemotherapy treatment. In response, the RCN funded a very successful pilot project through the RCN Quality Improvement Initiatives program (QI2), which in time was expanded to the Urgent Care Clinic (UCC) priority project. From its onset, The UCC project endeavored to provide timely support to patients on active treatment, thereby reducing symptom progression and avoiding unnecessary hospitalizations.
The UCC project entailed the creation of a dedicated physical space for urgent visits - in close proximity to chemotherapy treatment clinics and the expertise needed to support patients directed to the UCC. This project also supported the implementation of a telephone triage line staffed by specially trained nurses, using the Canadian Oncology Symptom Triage and Remote Support (COSTaRs) clinical guidelines for symptom management, and a software tool for staff to manage and document these calls. Importantly, the UCC increases patient comfort and empowerment by providing the support and education needed for patients to better understand their symptoms and be proactively involved in their self-management. From a provider perspective, the UCC allows for more efficient use of scarce Emergency Department (ED) resources by reducing preventable hospital admissions. Finally, the redirection of patients away from the ED helps to lower their risk of infection.
New clinical policies and procedures have been drafted for the management of Febrile Neutropenia, which is a common acute symptom that can be quite dangerous for cancer patients. As the UCC project progresses, clinical protocols for the management of common symptoms like pain, shortness of breath, nausea and vomiting will also be developed. Educational resources and teaching tools (e.g., videos, symptom tip sheets) for patients have also been created to help patients with self-management, especially during the pandemic when it was harder to access live (onsite) education sessions.
Since its inception, the UCC has consistently helped to avoid unnecessary ED visits, shown reduced emergency department visit rates, and improved patient satisfaction. In 2019, the project was recognized by the Ministère de la Santé et des Service Sociaux’s Programme Québécois de Cancérologie with a Prix de Cancérologie for excellence in Organisation des services. The RCN is very proud to continue to support the UCC, a truly exceptional and transformative initiative.
RCN video of RCN Urgent Care in Oncology