Ohio State Opens First Fully Integrated Cancer Emergency Department

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For patients with cancer who already have compromised immune systems, what may seem like a minor medical issue—ie, fever, dehydration, viral infection—can rapidly escalate into an emergency situation requiring care from a medical team familiar with managing the side effects of cancer treatment.

“Cancer patients develop a number of conditions that we want to be very well prepared for, to stabilize them and receive them in the hospital. We want to know about them in advance so we can give them the absolute best care—and fast,” said Thomas Terndrup, MD, Chair of the Department of Emergency Medicine at The Ohio State University Wexner Medical Center, Columbus.

Because the needs of cancer patients are often so complex, The Ohio State University Comprehensive Cancer Center—Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC-James) and Wexner Medical Center Emergency Department, have worked in close partnership to develop a clinical care model that combines the expertise of emergency medicine physicians and subspecialized oncologists working together in a cancer-specific emergency department to manage the emergency care needs of oncology patients. 

Cancer-Specific Care

“We’ve assembled a truly unique team that works together to establish protocols for delivering cancer-specific emergency care most effectively, and, in a way that allows us to clearly communicate that to the patients and their caregivers throughout the treatment process to reduce anxiety and stress in an already stressful situation,” Dr. Terndrup said. 

The oncology team, for example, will communicate with the cancer emergency treatment team in advance of the patient’s arrival in the James Emergency Department via the medical center’s electronic health record system. This ensures the staff on-site triaging the emergent patient understand the patient’s complete history and influencing factors before they arrive.

Clinical care guidelines have also been developed through a collaboration of oncologists at the OSUCCC-James and Wexner Medical Center emergency medicine physicians to guide emergent situations that occur in the cancer patient population—ie, severe dehydration, fever, or high calcium levels—so that both teams involved in the patient’s emergency care are following best-in-practice protocols to address that patient’s unique needs.

This unit, which includes 15 treatment stations, was designed specifically to address the unique needs of cancer patients and their family members.

“Emergency departments can be noisy and chaotic at times. The cancer treatment areas at the OSUCCC-James have been designed to reduce that intensity for cancer patients by offering enhanced privacy, including private bathrooms, natural light, and quiet space for family-physician conversations,” Dr. Terndrup said. “Private treatment rooms also allow us to isolate cancer patients in a negative air flow space. This was done to reduce exposure to infectious diseases in a population that is often at higher risk due to the nature of their disease and treatment.” ■