Haugstetter Corrine, Mason Robert, Sanmugarajah Jasotha, Hattingh H Laetitia
Cancer, Blood and Respiratory Medicine, Gold Coast Health, Southport, QLD 4215 Australia.
Medical Services, Clinical Governance and Research, Gold Coast Health, Southport, QLD 4215 Australia.
Emerg Cancer Care. 2022;1(1):11. doi: 10.1186/s44201-022-00011-8. Epub 2022 Oct 3.
The Cancer Urgent Assessment Clinic (CUAC) was an emergency department (ED) avoidance/unscheduled model of care implemented in response to the COVID-19 pandemic. The aim was to reduce the risk of COVID-19 exposure and infection by providing an alternative to ED for cancer patients while undergoing anticancer treatments.
The clinic incorporated a telephone triage process and face-to-face appointments 8am to 8pm, 7 days per week. CUAC operated between 23 March '20 and 31 July '20, led by a nurse practitioner candidate, oncology registrars, cancer nurse specialists, and overseen by oncology consultants. Evaluation followed a mixed-methods approach through (1) analysis of CUAC patient data, (2) comparison of ED cancer patient presentation data from a previous period (23 March 2019-31 July 2019), and (3) a patient survey.
In total, 400 patients were telephone triaged via CUAC, with 166 recorded as having avoided ED. There was a reduction in the number of cancer patient admissions to the ED short stay unit during the clinic period compared with the same time-period in 2019: 130 vs. 234, associated with 615 fewer hours. Patient satisfaction was positive particularly regarding ease of access, time to treatment, confidence in assessment and treatment of cancer-related concerns, and likelihood of presenting to hospital when unwell during the pandemic.
While initially being implemented to reduce the risk of COVID-19 exposure, this evaluation demonstrated the CUAC model was an efficient and potentially cost-saving model of care for the management of cancer patients with mild to moderate severity of disease and treatment-related concerns.
癌症紧急评估诊所（CUAC）是在应对新冠疫情期间实施的一种急诊科（ED）替代/非预约护理模式。其目的是通过为正在接受抗癌治疗的癌症患者提供急诊科之外的选择，降低新冠病毒暴露和感染风险。
该诊所纳入了电话分诊流程，并每周7天、每天上午8点至晚上8点提供面对面预约服务。CUAC于2020年3月23日至7月31日运营，由一名执业护士候选人、肿瘤学住院医师、癌症护理专家牵头，并由肿瘤学顾问监督。评估采用混合方法，包括（1）分析CUAC患者数据，（2）比较上一时期（2019年3月23日至2019年7月31日）急诊科癌症患者就诊数据，以及（3）患者调查。
通过CUAC共对400名患者进行了电话分诊，记录显示166名患者避免了前往急诊科。与2019年同期相比，诊所运营期间急诊科短期住院病房的癌症患者入院人数有所减少：130例对234例，减少了615小时。患者满意度较高，尤其是在就诊便利性、治疗等待时间、对癌症相关问题评估和治疗的信心以及疫情期间身体不适时前往医院就诊的可能性方面。
虽然最初实施该模式是为了降低新冠病毒暴露风险，但此次评估表明，CUAC模式是一种高效且可能节省成本的护理模式，适用于管理疾病严重程度为轻至中度且有治疗相关问题的癌症患者。
