A nurse practitioner – led model of care improves access, early assessment and integration of oncology services: an evaluation study

Purpose In Australia, the number of cancer cases has doubled since 1991 and is the second most common cause of death as reported by Chen, H., et al. (Supportive Care in Cancer, 2018. 27: p. 451-460). Chemotherapy, a common treatment, is known to cause distressing symptoms that often lead to a person presenting to an emergency department (ED). The aim of this study was to investigate whether a nurse practitioner (NP)–led model of care could improve cancer service integration and reduce hospital presentations. Methods This was an evaluation study for a new model of care that included (i) telephone helpline; (ii) urgent assessment clinic; and (iii) rapid day treatment consultation service. Results The utilisation rate was 337 telephone calls involving 157 patients in the 7-month pilot. The most common reason for calling the helpline was for symptom management ( n = 173, 51%), followed by education regarding treatment ( n = 61, 18%). As a result, 49% ( n = 165) of callers were given advice, information, or education; 22% ( n = 74) were referred on to other healthcare providers; and 11% (38) were admitted to hospital. Of the 38 admitted patients, 9 were admitted directly from the urgent NP-led clinic bypassing the ED. Conclusions The implementation of the NP-led model of care has reduced ED presentations, optimised symptom management, and streamlined patient telephone enquiries using validated clinical assessment tools (Jones 2018) within cancer services. The telephone helpline was available for the broader local health district community and was actively utilised. Patient surveys were overwhelmingly positive. The model of care has improved symptom management for patients and reduced ED workload and presentation rates.