Phone Triage & Acute Review Clinics: The Emerging Role Of The Oncology Specialist Nurse

Abstract Background Much of the work of a busy oncology day unit is undocumented, especially the work involved in phone triage during the working hours of 8am to 6pm. Phone calls from patients, their family doctors, palliative care teams, or from within the Hospital itself seeking advice form the majority of this aspect of the Specialist Oncology Nurse and Staff Nurses’ time. This project was performed to assess the nature of these calls and the broad advice given to the callers so that a dedicated Acute Review Specialist Oncology Nurse Clinic could be developed. Methods In conjunction with key oncology nurses and their medical oncologist colleagues a log to capture each answered call was developed. This centred on the date and time of the call, the source, the issue raised, the advice given, if advised to go to the Emergency Room the reason why, and other actions that were necessary. A form was completed per answered call, and collected at the end of the day. Data was recorded on a spreadsheet. All forms were annonymised with regard to patient identifiers. The forms were focused on whether the issue was successfully addressed within the day unit, the Hospital’s emergency room, the community services, or whether solely by the advice given over the telephone. Results A sample size of 252 incoming answered calls by the Oncology Nursing Staff to the Nurses’ station was analysed. Just over half these calls (52%) were made by patients/family members. Other calls related to internal questions such as from Interventional Radiology or other diagnostic areas of the Hospital (26%), pharmacies (7%), and family doctors (4%). The other 11% of calls were mainly from wards relating to advice on inpatients or seeking consults. Of the unwell patients calling for advice, near half (48%) were seeking advice on what action to take: stay at home or come to Hospital. 35% of patients were seeking either a new appointment or change in appointment date. The remaining 17% of patients were seeking non-emergency review by the medical oncology team. Conclusions This analysis of answered calls highlights the need for involvement of experienced oncology nurses in the triage of phone calls to a busy oncology day unit, and the need to develop an Acute Review Clinic, managed by an experienced oncology nurse specialist. Legal entity responsible for the study Beaumont Hospital Cancer Centre. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest.