Kay Wilson and Clare Small
Aneurin Bevan University Health Board
Project Background:
Approximately 10 Aneurin Bevan University Health Board (ABUHB) patients a month are referred via Velindre Cancer Centre (VCC) Treatment Helpline to Acute Care within ABUHB Hospitals.
Not all acute patients require immediate care, therefore most patients experience a long wait at the front door of A&E/MAU before being referred to by Oncology Specialists for further review.
Around 50% of these patients could be directly referred to Same Day Emergency Care (SDEC), enabling specialist Acute Oncology Service (AOS) needs to be addressed more quickly and reduce the time spent in acute care, thus improving patient outcome and experience.
Project Aims and Objectives:
Overarching Aim: Improve the patient experience for cancer patients impacted with complications of their treatment or disease progression.
- Objective 1: Work collaboratively with colleagues at ABUHB and VCC to co-design new pathway into SDEC.
- Objective 2: Reduce the pressure at the front door within A&E and MAU settings.
- Objective 3: Improve patient experience, by providing quicker access to specialist oncology advice, in a calmer and more comfortable setting.
- Objective 4: Improve bedside generalist education on Acute Oncology for colleagues.
Project Outcomes:
- Established and delivered a new pathway between services in two organisations.
- Reduced acute oncology patient waiting times by up to 8 hours.
- Reduced 3 patients Co2 footprint and travel costs by £5 each, providing care closer to home.
- Increased Acute Oncology Education for generalists in SDEC and flow centre.
- Improved patient experience, by providing quicker specialist oncology advice.
- Saved the LHB £4500 on admissions/bed days.
Project Impact:
12 patients supported, £4500+ saved in 10 weeks
Of the 12 patients seen, 3 were provided care closer to home than pre-implementation, resulting in a total saving of 90 miles and 191 minutes for those patients. This was a reduction in 85 kg of Co2, the same as offset by approximately 4 trees a year.
In A&E 78.2% of patients are seen in less than 12 hours. In SDEC our average patient stay was 4 hours, potentially saving each patient up to a further 8 hours wait
Patient Story:
36YO palliative patient called the VCC treatment helpline at 07:30, feeling generally unwell post chemo. They were advised to attend SDEC at GUH after they opened at 09:00, a 10 mile and 22-minute round trip. AOS reviewed the patient at 11am, gave IV fluids and discharged at 17:00, with an appointment for day return for repeated bloods.
The patient was home in time to have dinner and do bed time routines with their children.
Previously, IV fluids, and repeat bloods would have resulted in an overnight admission via A&E costing the health board approx. £500 per night.
