Siteman Cancer Center opens around-the-clock clinic for urgent care

Going to the emergency room can be stressful enough, but for cancer patients, an emergency room visit takes on a different set of issues.

For instance, cancer patients with lowered immune systems may wait in emergency room lobbies near patients with infectious diseases, such as the flu. In addition, given the complex nature of many cancer regimens and clinical trials, some emergency room staffers may be treating patients taking medications they’ve never heard of.

To provide around-the-clock care for cancer patients in need of urgent care, the Siteman Cancer Center at the School of Medicine and Barnes-Jewish Hospital (BJH) will open a 24/7 Cancer Care Clinic inside BJH’s north campus in March 2009.

“We’re trying to get oncology patients out of the emergency room because, for cancer patients, being around sick people for eight hours can be deadly,” said Amy Determann, manager of the 24/7 Cancer Care Clinic. “It’s a paradigm shift in care.”

The need for a 24/7 clinic was identified from records showing a number of Siteman Cancer Center patients in need of urgent care on a daily basis. For example, in 2006:

• A total of 1,438 visits (or about four Siteman patients per day) to the BJH emergency department among the bone-marrow transplant and medical oncology patient populations resulted in an admission.

• An average of five Siteman oncology patients per day were either inside BJH or at other hospitals waiting for an oncology patient bed.

• An estimated 20 Siteman oncology patients each week arrived at the BJH emergency department and were treated and released.

• An estimated 15 symptomatic Siteman patients were directed to local community hospitals’ emergency rooms weekly.

Those cancer patients, who most often need fluids or infusion, can now be treated 24/7 in an outpatient setting rather than a lengthy emergency room visit or an admission to an area hospital. Nurse practitioners familiar with cancer treatments and Siteman’s clinical trials will work with Washington University hospitalists in staffing the clinic.

BJH is spending $994,000 to build the clinic, which will be composed of seven infusion chairs, three private treatment rooms and one negative pressure room. Siteman’s bone marrow transplant weekend clinic will also relocate to the clinic.

The 24/7 Cancer Care Clinic is not available to cancer patients seen by non-Siteman Cancer Center physicians.

“Those patients may be on treatment regimens we’re unfamiliar with, and it’s important for those patients to work with their oncologist if they need urgent care,” said Determann, who makes clear the clinic isn’t a general emergency room, but rather for Siteman Cancer Center patients with symptoms related to oncology. She said those with acute problems like heart attack or stroke need to visit an emergency room.