Authors (including presenting author) :
Chan, DCW (1), Tsang JSC (2), Choi YF (2), Yiu TT (2), Chan KH (2), Choy YP (1), Lo YK (1), Ng V (2), Yip YT (2), Hon HC (1), Yuen KT (1), ACK Cheng (1)
Affiliation :
(1)Department of Oncology, Princess Margaret Hospital (2) Department of Pharmacy, Princess Margaret Hospital
Introduction :
Since the beginning of the coronavirus pandemic, the healthcare system has faced numerous challenges with great complexities requiring extreme measures to respond quickly and effectively to the devastating effects of COVID-19. While frontline healthcare workers struggle to serve their patients and communities, hospital officials are trying hard to resolve operational issues and manage scarcity of resources to keep the healthcare system resilient during the crisis. It is imperative for the government and healthcare officials to start planning ahead to return the society back to operational health. Responding to changing preferences and expectations from the community during the coronavirus pandemic, the process of recovery may need to contain the four Rs: responding, rebounding, rebuilding, and reimagining. Each R has a lot of work behind it. Responding is pretty obvious; it’s what we’re doing now. When the hospital admissions and clinic attendances have come down, how should we rebound to structure and deliver services because of these fundamental changes? We should rebuild the system by restructuring and reforms to avoid, mitigate, and prepare for a future health crisis of the kind that we are facing today. We need to ask ourselves ‘What is the new normal?’. How can we find a better alternative to care for the vulnerable oncology patient population? Could part of it be solved using telemedicine? If we were seeing 200 patients a day at the outpatient clinic, we need to reimagine how many of those can use telehealth if we challenge ourselves to rebuild in such a way that we are seeing only a 100 patients a day? What can the Oncology healthcare community do to adapt to the new normal? It is difficult to tell how long the pandemic will last, and it is impossible to know what will happen. But it is possible to consider the lessons learned from the past, and on that basis, to think and plan constructively about the future. The plan-ahead team would provide direction and coordination for the development and planning of the smooth resumption of operation of the oncology healthcare community with or without the need to coexist with COVID-19 in the near future. Triage protocols and multidisciplinary integrated clinics were implemented to enhance efficiency of service delivery and to reduce patient clinic dwelling time.
Objectives :
To implement triage protocols, a multidisciplinary integrated clinic for oncology patients to facilitate the delivery of systemic anti-cancer therapy with oncologists, oncology clinical pharmacists and oncology nurses under protocol to facilitate the efficiency of service delivery in a high volume oncology center in Hong Kong
Methodology :
Between June 2019 and November 2020, protocols were developed in a collaborative effect between oncologists, oncology clinical pharmacists, and oncology nurses. Training of oncology clinical pharmacists and oncology nurses to conduct thorough holistic assessment of oncology patients receiving systemic anticancer therapy were initiated. Pilot programs were tested using the protocol-based triage assessment approach to review patients requiring systemic anticancer therapy.
Result & Outcome :
Using a protocol-based multidisciplinary triage assessment approach, a total of 426 patients were assessed in the multidisciplinary clinic between 22 June to 30 Nov 2020, and 776 patient-episodes were recorded. The team effort greatly facilitated the efficiency of service delivery especially during the Covid19 pandemic to ensure rapid turnover of patients in the high volume cancer center at Princess Margaret Hospital. The Oncology Team would provide direction and coordination for the development and planning of the smooth resumption of operation of the oncology healthcare community with or without the need to coexist with COVID-19 in the near future. Triage protocols, multidisciplinary integrated clinics, and telemedicine should be the new status quo.
