Transformation of oncology inpatients: effects on length of stay and patient satisfaction

Abstract

Transformation of oncology inpatients: effects on length of stay and patient satisfaction The oncology department at Imperial College Healthcare Trust ranked last in the National Cancer Patient Experience Survey in 2011/12 and 2012/13. Length of stay (LOS) was above national average. General Medical Council surveys of junior doctors highlighted signifi cant issues with lack of senior review, education and working hours. Inpatient surveys echoed this with poor patient experience, and major complaints exposed lack of joint nursing and medical care. Restructuring the inpatient care pathway began in 2012 and centred around four target areas: 1) introduction of a ward based consultant; 2) defi ned admission criteria; 3) development of a cancer assessment unit; and 4) designated elective beds. Restructuring had a rapid effect on the service: total admissions per month declined from 246 in March 2013 to 183 in May 2014 and median LOS fell from 4.3 to 2 days over the same period (p<0.001). Complaints and serious incidents also fell and junior doctor satisfaction improved.

Economic and Logistic Challenges of Modern Oncology Healthcare

“…Economics of new cancer treatment drugs 2000e2016, demonstrating the numbers of drugs licenced in each time period, the average daily cost on treatment and the average cost of course of treatment (Costs based on the median durations of treatment obtained from the licencing trial publications and BNF list prices [4] consumed the important but modest efficiency savings that have occurred in cancer patient care from reorganisation of emergency and inpatient care [13]. With further scientific advances and over 700 new drugs in development, there does not seem to be any likely reduction in the pace of introduction new high-cost cancer therapies.…”

Acute medical and specialty support at a tertiary cancer centre: a collaboration to achieve high-quality care for acutely unwell patients with cancer

“…5,6 There is an increasing recognition of the need for collaboration between oncologists, acute physicians and specialists to improve the quality of care and outcomes for patients with cancer. 6,7 At The Christie, a tertiary oncology hospital in Manchester, a model has been developed to deliver acute medical and specialty support services in collaboration with a local university hospital -University Hospital of South Manchester.…”