Perceived Gaps in Oncologic Emergency Care for Patients with Cancer: A Qualitative Comparison of Emergency Medicine and Oncologist Physician Perspectives

被引:0
作者
Wattana, Monica K. [1 ]
Davenport, Moira [2 ]
Bischof, Jason J. [3 ]
Lindsay, Angela B. [4 ]
Pettit, Nicholas R. [5 ]
Menendez, Jazmin R. [1 ]
Harper, Kelsey [6 ]
Lipe, Demis N. [7 ]
Qdaisat, Aiham [1 ]
机构
[1] Univ Texas MD Anderson Canc Ctr, Dept Emergency Med, Houston, TX 77030 USA
[2] Allegheny Hlth Network, Allegheny Gen Hosp, Dept Emergency Med, Pittsburgh, PA 15212 USA
[3] Ohio State Univ, Dept Emergency Med, Wexner Med Ctr, Columbus, OH 43210 USA
[4] Virginia Commonwealth Univ, Dept Emergency Med, Richmond, VA 23298 USA
[5] Indiana Univ, Dept Emergency Med, Indianapolis, IN 46202 USA
[6] Brown Univ, Dept Emergency Med, Providence, RI 02912 USA
[7] Propharm Grp, Raleigh, NC 27601 USA
基金
美国国家卫生研究院;
关键词
emergency; care; oncology; gaps; knowledge; system constraints; interdisciplinary care; cancer; oncologist; emergency medicine; DEPARTMENT VISITS; MODEL;
D O I
10.3390/cancers17050828
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Objective: Providing high-quality, safe, and consistent care for patients with cancer in the emergency department (ED) poses unique challenges. To better understand these challenges, we surveyed oncologists and emergency medicine (EM) physicians across five institutions to identify key areas for improvement in oncologic EM. Methods: In this multi-institutional, cross-sectional qualitative study, a semi-structured survey was administered to EM attending and resident physicians and medical and surgical oncologists across five institutions in 2023. We assessed the open-ended questionnaire responses using thematic analysis; codes were created and collated to generate initial themes. The themes were then reviewed according to specialty for coherence and non-repetition and finalized. Results: Of the 302 surveys accessed, 185 (61.3%) had complete responses. Three main domains of issues emerged: systems-based challenges, direct patient care-related issues, and knowledge gaps. The issues most frequently perceived by oncologist survey respondents were long delays in care (41%), variability in care (25%), and communication issues between the EM physician and oncologist (14%). The issues most frequently perceived by EM physician survey respondents were knowledge gaps in cancer therapeutics (40%) and in general oncologic emergencies (23%); physician comfort level (14%); the timing and/or location of initial discussions about goals of care (13%); and challenges with the follow-up process (12%). Conclusions: Incorporating an interdisciplinary approach to patient care in the ED, improved EM oncologic education, and the development of oncologic specialized EDs may enhance the quality, safety, and consistency of care for patients with cancer in the ED.
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页数:16
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  • [1] Rivera D.R., Gallicchio L., Brown J., Liu B., Kyriacou D.N., Shelburne N., Trends in Adult Cancer-Related Emergency Department Utilization: An Analysis of Data From the Nationwide Emergency Department Sample, JAMA Oncol, 3, (2017)
  • [2] Cairns C., Kang K., Santo L., National Hospital Ambulatory Medical Care Survey: 2018 Emergency Department Summary Tables
  • [3] Kratzer T.B., Siegel R.L., Miller K.D., Sung H., Islami F., Jemal A., Progress Against Cancer Mortality 50 Years After Passage of the National Cancer Act, JAMA Oncol, 8, pp. 156-159, (2022)
  • [4] Hsu J., Donnelly J.P., Moore J.X., Meneses K., Williams G., Wang H.E., National characteristics of Emergency Department visits by patients with cancer in the United States, Am. J. Emerg. Med, 36, pp. 2038-2043, (2018)
  • [5] Yang Z., Yang R., Kwak M.J., Qdaisat A., Lin J., Begley C.E., Reyes-Gibby C.C., Yeung S.J., Oncologic emergencies in a cancer center emergency department and in general emergency departments countywide and nationwide, PLoS ONE, 13, (2018)
  • [6] Barbera L., Taylor C., Dudgeon D., Why do patients with cancer visit the emergency department near the end of life?, CMAJ, 182, pp. 563-568, (2010)
  • [7] Gallaway M.S., Idaikkadar N., Tai E., Momin B., Rohan E.A., Townsend J., Puckett M., Stewart S.L., Emergency department visits among people with cancer: Frequency, symptoms, and characteristics, J. Am. Coll. Emerg. Physicians Open, 2, (2021)
  • [8] Alishahi Tabriz A., Turner K., Hong Y.-R., Gheytasvand S., Powers B.D., Elston Lafata J., Trends and Characteristics of Potentially Preventable Emergency Department Visits Among Patients With Cancer in the US, JAMA Netw. Open, 6, (2023)
  • [9] Caterino J.M., Adler D., Durham D.D., Yeung S.J., Hudson M.F., Bastani A., Bernstein S.L., Baugh C.W., Coyne C.J., Grudzen C.R., Et al., Analysis of Diagnoses, Symptoms, Medications, and Admissions Among Patients With Cancer Presenting to Emergency Departments, JAMA Netw. Open, 2, (2019)
  • [10] Lash R.S., Bell J.F., Reed S.C., Poghosyan H., Rodgers J., Kim K.K., Bold R.J., Joseph J.G., A Systematic Review of Emergency Department Use Among Cancer Patients, Cancer Nurs, 40, pp. 135-144, (2017)