273MO - A supportive and expanding nurse led model of care, symptom urgent review clinic (SURC)

Background

Cancer patients undergoing systemic anti-cancer therapies (SACT) invariably experience toxicities precipitating presentations to Emergency Departments (ED). With the ongoing COVID-19 pandemic, it is imperative to continue to keep vulnerable immunocompromised patients out of hospital and encourage patients to contact SURC when symptoms develop. Peninsula Health (PH), SURC service was initiated post completion of a 12-month funded grant through the Victorian Government and has grown rapidly since its commencement. This nurse-led SURC model of care has been reported to achieve an investment return of $1.73 for every dollar invested.

Methods

ED presentations of Peninsula Health Oncology/Haematology patients pre- and post-SURC commencement were examined if potentially avoidable presentations have reduced. Ongoing SURC Episodes of care (Educations, phone, and physical attendances) between January 2022 to September 2022 captured in the SURC Access Database. Patient experience surveys were conducted post SURC phone contact and physical attendance if unwell. Patients and clinicians' surveys are ongoing.

Results

Intermediate statistical data (COSA2021) collated June 2021 to December 2022 post-grant, we observed 43.30% reduction in ED presentations within SURC operation hours by patients considered SURC eligible when compared to pre-SURC figures. The SURC from January 2022 to September 2022 has recorded, 2567 episodes of care, provided to 601 individuals; educations (12.43%), incoming phone triage (45.77%), outgoing phone triage (31.40%), and attendances (10.40%). Most frequent SURC contacts were for care-coordination (28.43%), gastrointestinal symptoms (17.97%), diagnostics (8.81%), pain management (7.56%),)and medication advice (6.23%). Notably, more than one-third indicated they would have done nothing (36.93%) with 7.13% indicating they would have presented to ED without SURC. Closely aligning with the local cancer prevalence rates, the commonest tumour streams are breast (22.63%), lung (17.14%), and colorectal (15.64%).

Conclusions

The SURC model of care continues to be an invaluable resource at PH to support cancer patients undergoing SACT which allows prompt access to specialist care while avoiding emergency presentations in the ambulatory setting. The model continues to expand post an additional government grant “SURC-additional support during COVID-19 and recovery” to increase additional support to vulnerable populations.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.