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Date of Graduation
12-15-2023
Document Type
Dissertation
Degree Name
Doctor of Nursing Practice (DNP)
Department
School of Nursing
Advisor(s)
Jeannie Corey
Elizabeth Lester
Abstract
Patients receiving cancer care in the outpatient setting may often require unscheduled, acute management of symptoms. An oncology urgent care clinic (UCC) was implemented to provide symptom management for these patients outside of the emergency department (ED) at an academic medical center. A program evaluation was performed to assess the impact of the UCC on ED utilization and patient outcomes. The project methodology is the Predisposing, Reinforcing and Enabling Constructs in Educational Diagnosis-Policy, Regulatory and Organizational Constructs in Educational and Environmental Development (PRECEDE/PROCEED) method of program evaluation with additional evaluation of outcomes via the Institutes of Healthcare Improvement (IHI) triple aim (Green & Kreuter, 2004). A retrospective electronic medical record (EMR) data review method was utilized to analyze pre-(2018) and post-(2020-2022) implementation encounters in the ED and UCC. The UCC experienced statistically significant growth over the three-year study period. Patients were treated and discharged to follow up with their primary oncology teams 77 % of the time, transferred to a higher level of care 14% of the time, and only returned to the ED within 24 hours 2% of the time. When reviewed by month, there is a positive correlation between UCC volume and ED utilization, however there was no statistically significant impact on ED utilization during the study period. The average charges for patient encounters in the UCC demonstrated a $3101 reduction in charges for patients versus a visit to the ED during the same period. These outcomes demonstrate that the UCC provides high-quality and cost-effective care for the oncology population and is a safe alternative to the ED for the management of symptom related complaints.
Recommended Citation
Noble, Melody D., "Evaluating utilization and outcomes for an outpatient oncology urgent care center" (2023). Doctors of Nursing Practice (DNP) Final Projects, 2020-current. 34.
https://commons.lib.jmu.edu/dnp202029/34
