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 can take."
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 that well."
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.