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Emergency admissions and subsequent inpatient care through an emergency oncology service at a tertiary cancer centre: service users’ experiences and views

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Abstract

Purpose

Avoiding unnecessary emergency admissions and managing those that are admitted more effectively is a major concern for both patients and health services. To generate evidence useful for improving services for direct patient benefit, this study explores service users’ views and experiences of emergency admissions and subsequent inpatient care.

Methods

Participants were recruited during a cancer-related emergency admission from a tertiary cancer centre with an emergency oncology service and emergency department. Semi-structured interviews were conducted with 15 patients and 12 carers post hospital discharge. Interview transcripts were analyzed using framework analysis.

Results

Twenty patients experienced 43 emergency admissions over 6 months. Most admissions (35/43) followed patients presenting acutely or as emergencies with cancer treatment side effects. Most admissions (35/43) were directly to an oncology ward following specialist advice, review and triage, and thus unavoidable. Participants experienced outstanding inpatient care because of the following: prompt and effective symptom control and stabilization of acute conditions; continuity of cancer care and coordination between acute and long-term treatment; satisfactory professional-patient communication and information sharing; responsive, motivated and competent staff; and less restrictive visiting times. Gaps in care were identified.

Conclusions

Many emergency admissions are necessary for people with cancer. Future work should focus on improving easy access to specialist advice and triage, and the process of admission; providing rapid palliation of symptoms and prompt stabilization of acute conditions, and satisfactory inpatient care; closing the circle of care for patients by actively involving primary care and palliative/end-of-life care services to address the complex needs of patients and carers.

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Acknowledgements

We are grateful to patients and their carers for their participation during a difficult time. We thank Thomas Hammond for his admin support and Sarah Smith for participant recruitment.

Funding

This work was supported by a University of Hull Endowment award from Yorkshire Cancer Research (Ref: HEND001).

Author information

Authors and Affiliations

  1. Institute of Clinical and Applied Health Research, The Allam Medical Building, University of Hull, 3rd Floor, Cottingham Road, Hull, HU6 7RX, UK

    Hong Chen, Miriam Johnson, Julie Seymour & Una Macleod

  2. Queen’s Centre for Oncology and Haematology, Hull and East Yorkshire Hospitals NHS Trust, Castle Hill Hospital, Castle Road, Cottingham, HU16 5JQ, UK

    Elaine Boland

Authors
  1. Hong Chen
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  2. Miriam Johnson
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  3. Elaine Boland
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Correspondence to Hong Chen.

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Competing interests

The authors declare that they have no competing interests.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Chen, H., Johnson, M., Boland, E. et al. Emergency admissions and subsequent inpatient care through an emergency oncology service at a tertiary cancer centre: service users’ experiences and views. Support Care Cancer 27, 451–460 (2019). https://doi.org/10.1007/s00520-018-4328-5

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  • DOI: https://doi.org/10.1007/s00520-018-4328-5

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