BACKGROUND:Patients receiving chemotherapy commonly develop symptoms due to both underlying disease and adverse effects of treatment. A formalised pathway for early chemotherapy symptom review and management was needed which initiated the introduction of a nurse led Symptom Urgent Review Clinic (SURC) in Western Health’s Chemotherapy Day Unit (CDU).
METHODS:A detailed triage system was designed and implemented allowing a variety of management options that could be provided. SURC functions as a phone-in or walk-in clinic where patients, carers and clinicians are encouraged to utilise as soon as symptoms occur. Pre-chemotherapy education is also provided to all patients referred to CDU.
RESULTS:In the first nine months, SURC was utilised by 439 patients accounting for an average of 100 episodes per month. Of the patients who received SURC pre-chemotherapy education (n=145), 32% presented to ED, an improvement from baseline data of 41%. A reduction in the percentage of patients being admitted for 24 hours or less (from 20% to 10%) was also observed.Spot surveys (n=42) revealed 98% of patients are either extremely satisfied or very satisfied and 75% of patients felt confident with self-management of symptoms. A large proportion of patients revealed they would have gone to ED (74%); phoned or come into the CDU (48%) had SURC not existed.
CONCLUSION:SURC is an innovative solution for early assessment and management of chemotherapy patients who experience toxicity. SURC has resulted in improved patient confidence in managing chemotherapy symptoms, clinician satisfaction with care and a significant reduction in ED admissions. SURC is now a permanent clinic at WH where it represents