Emergency admissions and subsequent inpatient care through an emergency oncology service at a tertiary cancer centre: service users’ experiences and views

Chen, Hong; Johnson, Miriam; Boland, Elaine; Seymour, Julie; Macleod, Una

Abstract

Purpose Avoiding unnecessary emergency admissions and managing those that are admitted more effectively is a major concern for both patients and health services. To generate evidence useful for improving services for direct patient benefit, this study explores service users’ views and experiences of emergency admissions and subsequent inpatient care.

Methods Participants were recruited during a cancer-related emergency admission from a tertiary cancer centre with an emergency oncology service and emergency department. Semi-structured interviews were conducted with fifteen patients and twelve carers post hospital discharge. Interview transcripts were analyzed using framework analysis.

Results Twenty patients experienced 43 emergency admissions over six months. Most admissions (35/43) followed patients presenting acutely or as emergencies with cancer treatment side-effects. Most admissions (35/43) were directly to an oncology ward following specialist advice, review and triage and thus unavoidable. Participants experienced outstanding inpatient care because of: prompt and effective symptom control and stabilization of acute conditions; continuity of cancer care and coordination between acute and long-term treatment; satisfactory professional-patient communication and information sharing; responsive, motivated and competent staff; and less restrictive visiting times. Gaps in care were identified.

Conclusions Many emergency admissions are necessary for people with cancer. Future work should focus on: improving easy access to specialist advice and triage, and the process of admission; providing rapid palliation of symptoms and prompt stabilization of acute conditions, and satisfactory inpatient care; closing the circle of care for patients by actively involving primary care and palliative/end-of-life care services to address the complex needs of patients and carers.

Citation

Chen, H., Johnson, M., Boland, E., Seymour, J., & Macleod, U. (2019). Emergency admissions and subsequent inpatient care through an emergency oncology service at a tertiary cancer centre: service users’ experiences and views. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 27(2), 451–460. https://doi.org/10.1007/s00520-018-4328-5

• Journal Article Type: Article
• Acceptance Date: Jun 20, 2018
• Online Publication Date: Jun 30, 2018
• Publication Date: 2019-02
• Deposit Date: Jul 3, 2018
• Publicly Available Date: Jul 1, 2019
• Journal: Supportive Care in Cancer
• Print ISSN: 0941-4355
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 27
• Issue: 2
• Pages: 451–460
• DOI: https://doi.org/10.1007/s00520-018-4328-5
• Keywords: Oncology
• Public URL: https://hull-repository.worktribe.com/output/908318
• Publisher URL: https://link.springer.com/article/10.1007%2Fs00520-018-4328-5
• Contract Date: Jul 5, 2018