Hospitalists on an Inpatient Tertiary Care Oncology Teaching Service

Koo, Douglas J.; Goring, Tabitha N.; Saltz, Leonard B.; Kerpelev, Marina; Kumar, C. Bala; Salvit, Cori; Chung, Helen; Abou‐Alfa, Ghassan K.; Martin, Steven C.; Egan, Barbara

doi:10.1200/jop.2014.000661

Cited by 12 publications

(13 citation statements)

References 12 publications

(10 reference statements)

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“…A separate study of patients with gastrointestinal cancer found that the most common reasons for unplanned hospitalization were fluid and electrolyte disorders, intestinal obstruction, and pneumonia . Among our patients on the gastrointestinal oncology service, fever and pain were the 2 most common reasons for hospitalization . The underlying natural disease course of cancer also deserves attention, and it is useful for patients and their families to understand this context.…”

Section: Practical Guidelines For Coordinating Care In Hospitalized Pmentioning

confidence: 87%

“…In addition to being board certification in internal medicine, 1 member is board certified in medical oncology and 4 members are board certified in hospice and palliative medicine. In a recent article, we describe our experience with patients on our inpatient gastrointestinal oncology service; patients with pancreatic cancer accounted for a quarter of all inpatient admissions, and 90% of all patients had been diagnosed with metastatic disease …”

Section: Hospital Medicine At Mskccmentioning

confidence: 99%

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Hospitalists caring for patients with advanced cancer: An experience‐based guide

Koo

Tonorezos

Kumar

et al. 2015

Journal of Hospital Medicine

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Every year, nearly five million adults with cancer are hospitalized. Limited evidence suggests that hospitalization of the cancer patient is associated with adverse morbidity and mortality. Hospitalization of the patient with advanced cancer allows for an intense examination of health status in the face of terminal illness and an opportunity for defining goals of care. This experience-based guide reports what is currently known about the topic and outlines a systematic approach to maximizing opportunities, improving quality, and enhancing the well-being of the hospitalized patient with advanced cancer.

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Section: Practical Guidelines For Coordinating Care In Hospitalized Pmentioning

confidence: 87%

Section: Hospital Medicine At Mskccmentioning

confidence: 99%

Hospitalists caring for patients with advanced cancer: An experience‐based guide

Koo

Tonorezos

Kumar

et al. 2015

Journal of Hospital Medicine

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“…common cancer-related complications related to systemic therapy, progression of disease, and end of life, have already created value in inpatient oncology by reducing length of stay and average costs per patient. 15,26,27 We believe that a similar model of provider subspecialization in the OECC can provide further value through not only more efficient, cost-effective delivery of urgent care but also reduced overall admission rates compared with those historically observed in EDs.…”

Section: Discussionmentioning

confidence: 99%

Impact of a Dedicated Cancer Urgent Care Center on Acute Care Utilization

Rothberg

Canavan

Mun

et al. 2022

JCO Oncology Practice

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PURPOSE: Acute care imposes a significant burden on patients and cancer care costs. We examined whether an advanced practice provider-driven, cancer-specific urgent care center embedded within a large tertiary academic center decreased acute care use among oncology patients on active therapy. MATERIALS AND METHODS: We conducted a quasi-experimental study anchored around the Oncology Extended Care Clinic (OECC) opening date. We evaluated two parallel 4-month periods: a post-OECC period that followed a 5-month run-in phase, and the identical calendar period 1 year earlier. Our primary outcomes included all emergency department (ED) presentations and hospital admissions during the 3-month window following the index provider visit. We used Poisson models to calculate absolute pre-OECC v post-OECC rate differences. RESULTS: Our cohort included 2,095 patients in the pre-OECC period and 2,188 in the post-OECC period. We identified 32.6 ED visits/100 patients and 41.2 hospitalizations/100 patients in the pre-OECC period, versus 28.2 ED visits/100 patients and 26.1 hospitalizations/100 patients post-OECC. After adjusting for age, sex, race and ethnicity, and practice location, we observed a significant decrease of 4.6 ED visits/100 patients during the post-OECC period (95% CI, –8.92/100 to –0.28/100; P = .04) compared with the pre-OECC period. There was no significant association between the OECC opening and hospitalization rate (rate difference: –3.29 admissions/100 patients; 95% CI, –8.24/100 to 1.67/100; P = .19). CONCLUSION: Establishing a cancer-specific urgent care center was significantly associated with a modest decrease in emergency room utilization but not with hospitalization rate. Barriers included clinic capacity, patient awareness, and physician comfort with advanced practice provider autonomy. Optimizing workflow and standardizing clinical pathways can create benchmarks useful for value-based payments.

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“…The hospitalist model of inpatient care delivery is an accepted standard of care [1,2], and there are now numerous examples of hospitalists managing hospitalized patients with cancer, with similar outcomes to those cared for on medical oncologist-led services [3][4][5][6][7]. The perceptions of oncologists about inpatient cancer care delivery and the hospitalist model are unknown.…”

Section: Introductionmentioning

confidence: 99%

The Hospitalist Model and Oncology: Oncologist Opinions About Inpatient Cancer Care Delivery

et al. 2020

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Hospitalists, rather than oncologists, are increasingly providing inpatient medical care to hospitalized patients with cancer, yet the opinions of oncologists regarding this model of care delivery are unknown. A survey was conducted assessing these opinions and experiences with inpatient cancer care delivery at a tertiary cancer center. Only 30% of oncologists agreed that caring for hospitalized patients with cancer was an efficient use of their time, and most believed a hospitalist service allowed them to pursue other interests. Most had a positive experience with hospitalists, agreeing that hospitalists can diagnose and manage toxicities of cancer therapy, exhibit professionalism, and communicate with them and their patients appropriately. Hematologic malignancy specialists were more likely to value inpatient service time and had less confidence in the ability of hospitalists. Overall, the hospitalist model was generally accepted by oncologists and will continue to be an important part of oncologic care delivery.

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Hospitalists on an Inpatient Tertiary Care Oncology Teaching Service

Cited by 12 publications

References 12 publications

Hospitalists caring for patients with advanced cancer: An experience‐based guide

Hospitalists caring for patients with advanced cancer: An experience‐based guide

Impact of a Dedicated Cancer Urgent Care Center on Acute Care Utilization

The Hospitalist Model and Oncology: Oncologist Opinions About Inpatient Cancer Care Delivery

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