Cancer Rapid Assessment Unit (CRAU)
Project description
The Canberra Region Cancer Centre (CRCC) provides Medical Oncology, Radiation Oncology, Haematology and Palliative Care Services for the region. In 2013, a Cancer Rapid Assessment Unit (CRAU) was created to facilitate timely review, diagnosis and intervention of cancer and chemotherapy related toxicities and side effects.
Malignant ascites and pleural effusions (fluid build-up in the abdomen and pleural spaces) are common complications of a cancer diagnosis that can cause noticeable symptoms and impair the quality of life (QOL) of patients. Although these conditions may respond to systemic therapies (such as hormonal agents, chemotherapy, targeted agents, and immune checkpoint inhibitors), these complications often require interventions via paracentesis and thoracocentesis for diagnostic and/or ongoing therapeutic and symptom management.
Our planned project with in the CRAU is to implement a Point of Care Ultrasound (POCUS) intervention procedure service within the CRAU to provide these interventional procedures in both an acute/immediate setting along with routine or less frequent timeframes within the CRAU as alternative to the traditional services located in the ED, inpatient services, medical imaging, or day surgery settings.
Outcomes
This project aims to reduce the impact on the patient these conditions can cause through:
Reducing the time to diagnosis
Facilitating treatment availability with the overall aim of reducing burden, frustration and discomfort caused due to known delays in access to this intervention.
Improve patient satisfaction and expedition of care associated with this intervention.
Improve early identification and intervention of these conditions.
Increase positive patient outcomes.
Improvement Patient QOL via less time spent in medical facilities, less time wasted sourcing these procedures in alternative clinical or outpatient services and a reduction in avoidable hospital admissions or on ancillary services further reduced.
An overall preference of our patients that is echoed by all CRCC clinicians is for care associated with diagnosis be managed in our service rather than the ED or ancillary interventions units. This has been shown as patients report that they feel their needs are better understood and addressed in a more comprehensive and holistic way with CRCC clinicians and in an environment they were more familiar with.
Impact on the healthcare professional and the healthcare institution
The impact of this CRAU project on HCPs and the HC institution will be:
A reduction in cancer related presentations to the ED
Reduction of unscheduled cancer related admissions to hospital.
This will prove to show not only a monetary benefit but a huge benefit on patient flow and bed availability.
Average length of stay in the CRAU will be shorter than that seen in the ED for similar presentations.
Hospital length of stay will also be reduced.
Interventions managed through the CRAU or by telephone consultation reduced by 25% that would have otherwise presented to the ED.
You can download the Rapid Assessment Unit Flyer here.
Proposer
Department of Medical Oncology,
Canberra Region Cancer Centre,
Cancer & Ambulatory Support,
The Canberra Hospital
Yamba Drive
Garran ACT 2605
Project contact person:
Professor Desmond Yip - Clinical Director and Senior Staff Specialist in Medical Oncology
desmond.yip@act.gov.au
Other project team members:
Mrs Katherine Wakefield (CRCC Director of Nursing, Canberra Region Cancer Centre)
Mrs Julianne Siggins (CRCC Ag Assistant Director of Nursing, Canberra Region Cancer Centre)
Mrs Chris Twyford (Clinical Nurse Consultant Radiation Oncology, Cancer Rapid Assessment Unit)
Mr James Slade (Nurse Practitioner, Cancer Rapid Assessment Unit, Canberra Region Cancer Centre)
Mr Timothy Wolf (Advanced Practice Nurse, Cancer Rapid Assessment Unit, Canberra Region Cancer Centre.)