Oncology Hematology Care, Cincinnati, OH
Molly Mendenhall, Amy Sheldrick, Karyn M. Dyehouse, Andrew S Guinigundo, David Michael Waterhouse
Background: Team-based implementation of care is a foundational tenant to reducing avoidable ER visits and hospitalizations. This care strategy supports the OCM mission of improving quality and reducing cost through practice transformation. Methods: Comprehensive care team: Physician, Advanced Practice Provider, Nurse Navigator, Financial Navigator, Phone Triage Nurse; Consistent Message: “Call Us Early – Call Us First” campaign. Verbal and written instructions at all staff member touch points, emphasizing patient responsibility to call before going to the hospital; Supporting infrastructure: 2-hour teaching visit with the entire care team prior to all new treatments; Triage Phone Unit, COME HOME (Barbara McAneny, M.D.) triage pathways – 38 symptom and 27 symptom f/u pathways modified; Blocked time-slots at all offices for same-day APP triage appts; Proactive ER and hosp f/u calls. Results: 2017 phone triage data: 9,841 total symptoms calls. 2,476 same day visits. 338 ER saves. 67 ER f/u calls (Nov/Dec 17’ only). OCM pt survey scores improved and internal Netpromoter scores remained stable. Conclusions: A comprehensive team-based patient navigation strategy, supported by consistent “Call Us First” messaging, symptom pathways and same-day patient access, resulted in decreased hospitalization without commensurate increases in ER visits or 24hr observation stays. Pt satisfaction was not impacted negatively.
Apr 15’– Mar 16’ | Oct 15’– Sept 16’ | Jan 16’– Dec 16’ | Apr 16’– Mar 17’ | Jul 16’– Jun 17’ | |
---|---|---|---|---|---|
OHC Inpt Admits | 26.3 | 25.5 | 24.8 | 23.4 | 22.6 |
Admits, Practices in Risk Cohort | 26.8 | 26.2 | 25.4 | 25.8 | 25.9 |
OHC Unplanned Readmits < 30 Days of Discharge | 6.4 | 5.4 | 5.6 | 4.9 | 4.9 |
Unplanned Readmits < 30 Days of Discharge, Practices in Risk Cohort | 6.6 | 6 | 5.7 | 5.5 | 5.6 |
OHC ED Visits not Leading to Admits or Obsv Stay | 15.7 | 16.2 | 16.4 | 16.3 | 17 |
ED Visits not Leading to Admits or Obsv Stay, Practices in Risk Cohort | 18.3 | 18.3 | 18.2 | 18.5 | 18.6 |
Disclaimer
This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org
Abstract Disclosures
2022 ASCO Quality Care Symposium
First Author: Sara Toth
2023 ASCO Annual Meeting
First Author: Mihir Shah
2024 ASCO Quality Care Symposium
First Author: Deepa Shah
2019 ASCO Quality Care Symposium
First Author: Anamika Chaudhuri