A combination of strategic reports and guidance, in addition to experience and local audit, led the Beatson team to develop a redesign proposal for increasing day case chemotherapy capacity, establishing a 24-hour telephone helpline to better support patients and staff, and an assessment unit to review patients timely and effectively.
The aim was to improve unscheduled care for patients with cancer, and to meet the increasing demand for day case chemotherapy. The Acute Oncology Assessment Unit (AOAU) is an 8-bedded nurse-led day case area where all emergency admissions to the cancer centre, patients presenting to clinics unwell, and those who become unwell during radiotherapy or chemotherapy treatment, are seen. Patients phoning the helpline can also be seen in AOAU avoiding the need to attend the Emergency Department.
Reports identified issues such as prevalence of cancer patients in acute service beds, inadequate communication and IT, and poor patient access to specialist advice and care 24/7.
An audit at the Beatson West of Scotland Cancer Centre BWoSCC showed variation amongst staff and practice about what information to give patients on treatment, what to do if they were unwell and what advice to give patients at home. Patients were unsure who to phone for advice, and contacted various sources. This resulted in patients receiving advice of varying quality.
A combination of strategic reports and local audits prompted a redesign proposal for increasing day case chemotherapy capacity, establishing a 24 hour telephone helpline, and setting up an assessment unit.
Among its objectives, the team wanted to establish an eight-bed Acute Oncology Assessment Unit (AOAU) and a 24 hour Cancer Treatment Helpline (CTH/helpline) within the AOAU. They aimed to increase chemotherapy day case capacity by reconfiguring existing inpatient resources to include an additional 11 day case beds.
The specific objectives of the AOAU and Cancer Treatment Helpline were to assess and manage patients dealing with the complications of cancer treatment, and to provide improved access to specialist oncology advice and care, at the right place at the right time.
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