SAN DIEGO--Because of the new realities of health care, it is
time to rethink the concept of traditional oncology units, Jeanne
T. Reardon, RN, said at the 8th Annual Cancer Care Symposium sponsored
by the Society for Ambulatory Care Professionals and Health Technology
Assessment of the American Hospital Association.
"The oncology unit as the flagship of the oncology program
is not going to be there anymore," said Ms. Reardon, the
administrative director of the cancer program at Methodist Hospitals
of Dallas. "You will require inpatient beds, but if that's
the main focus of your program, it's time to rethink it."
In the future, she said, institutions will increasingly be reaching
out to patients through multisite services, outpatient programs,
and even mobile care. "Some hospitals will pack up their
cancer care services, such as infusion therapy and laboratory
equipment, and travel through the community to workplaces, schools,
and homes," she said.
Many institutions are struggling with the question of what to
do with their oncology units. "Having spent a lot of time,
energy, and resources to develop these specialty cancer units
and programs, people are now looking at their patient volumes
and saying that it may be time to close them," Ms. Reardon
said. "That's an option, but it's not the only option you
Ms. Reardon's own institution is tackling this issue, brought
about by the "compulsion" that gripped it and other
medical institutions in earlier years to construct new inpatient
facilities. "We built a big 350+ bed inpatient facility,"
she said, "and guess what, folks, it's not working out all
Some hospitals have abandoned sub-specialty oncology units and
moved forward with a combination concept. These institutions try
to utilize medical oncol-ogy nurses by cross training them in
surgical care so they can care for both medical and surgical oncology
patients, Ms. Reardon said.
Other hospitals have combined inpatient and outpatient facilities
into a single "day unit," utilizing the same nursing
staff for both inpatients and outpatients. "It's an interesting
concept because much of the outpatient care at this time is just
as acute as what's on the inpatient side," she said. Many
outpatients are going to be in the "day" unit for 16
hours, requiring two nursing shifts.