Making steps to decrease emergency room visits in patients with cancer: Our experience after participating in the ASCO Quality Training Program.

2016 
51 Background: Overutilization of emergency room services by oncology patients is a known problem associated with increased admission rates and health care expenditure. A review of our oncology patients’ emergency room (ER) visits from January to May 2015 demonstrated that 48% of ER visits happened during office hours. Consequently a rapid cycle quality improvement project was developed with an aim to decrease ER visits by 30% by September 2015. Methods: A multidisciplinary team completed an action plan, starting with a project charter and definition of aim statement. A process map for patient scheduling/triage was created. A cause and effect diagram helped identify potential causes patient utilization of the ER. Diagnostic data were obtained querying our EMR (EPIC) for ER visits from January to May 2015. A Pareto chart identified Breast, Hematology and GI malignancies as main diagnosis utilizing the ER. Plan-do-study-act (PDSA) #1 began with development of a protocol to guide the handling of patients' ca...
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