POPULATION-BASED NURSE INITIATED CANCER SYMPTOM MANAGEMENT: DESCRIPTION OF AN ONGOING PROGRAM

2.50
Hdl Handle:
http://hdl.handle.net/10755/165024
Category:
Abstract
Type:
Presentation
Title:
POPULATION-BASED NURSE INITIATED CANCER SYMPTOM MANAGEMENT: DESCRIPTION OF AN ONGOING PROGRAM
Author(s):
Kamhi, Carol; Weininger, Richard; Hays, RamonaMicholovich, Elizabeth
Author Details:
Carol Kamhi, MSN, APRN, BC, Clinical Supervisor, Oxford Health Plans, A United Healthcare Company, Trumbull, Connecticut, USA, email: ckamhi@oxhp.com; Richard Weininger, MD, OncoMetrix, Inc. Claverack, New York; Ramona Hays, RN, BSN, Oxford, a United Healthcare Company, Trumbull, Connecticut; Elizabeth Micholovich, BS, MPA, SecureHorizons, a United Healthcare Company, Trumbull, Connecticut
Abstract:
A major Northeast health insurance company recognized an opportunity to reduce complication prevalence and related hospitalizations in patients undergoing cancer treatments using an innovative nurse case management model. This program's purpose is to reduce admissions related to preventable treatment and disease complications. This telephonic care management (TCM) model was designed for patients undergoing active chemotherapy or radiation cancer treatments focusing on those at highest risk of preventable hospitalization. Selection criteria were developed and tested to identify those patients at highest risk. These criteria were used to create a "risk index" based on: diagnosis (excluding childhood malignancies and acute leukemias); disease stage; particular treatments (e.g.: platinum based therapy); caregiver support; and hospital admission history. The risk index was used to stratify the TCM interventionÆs intensity provided to the patient. Preventable hospitalization criteria were developed based on ICD- 9 codes to create a matrix from which hospital claims could be used to identify preventable hospitalizations for nausea, vomiting, diarrhea, dehydration, infection, hematologic abnormalities, respiratory problems, and others. Telephonic nursing assessment tools were created to evaluate signs and symptoms of treatment complications to intervene proactively with patients and their healthcare team to help establish care in the appropriate setting. Program results were assessed by the ability to demonstrate a reduced level of preventable hospital admissions. Admissions were assessed for ICD-9 codes fitting these criteria over time and compared to an unmanaged population. Initial, early, results have shown a positive effect on complication measures: prevalence, admits per 1,000, admits, and average length of stay for managed patients versus those patients who did not receive case management. These outcome parameters represent core goals for oncology nurses. By intervening proactively with patients and their healthcare team and helping support timely care in the appropriate setting, preventable hospitalizations are reduced. The approach and developed tools outlined here can be adapted for use by oncology nurses in other clinical settings to reduce morbidity of cancer and related treatments. Additional analysis will be conducted on this modelÆs impact on enhancing the health care teamÆs care coordination as it relates to preventable hospitalizations, treatment outcomes, and patientsÆ quality of life.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2007
Conference Name:
32nd Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
Las Vegas, Nevada, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titlePOPULATION-BASED NURSE INITIATED CANCER SYMPTOM MANAGEMENT: DESCRIPTION OF AN ONGOING PROGRAMen_GB
dc.contributor.authorKamhi, Carolen_US
dc.contributor.authorWeininger, Richarden_US
dc.contributor.authorHays, RamonaMicholovich, Elizabethen_US
dc.author.detailsCarol Kamhi, MSN, APRN, BC, Clinical Supervisor, Oxford Health Plans, A United Healthcare Company, Trumbull, Connecticut, USA, email: ckamhi@oxhp.com; Richard Weininger, MD, OncoMetrix, Inc. Claverack, New York; Ramona Hays, RN, BSN, Oxford, a United Healthcare Company, Trumbull, Connecticut; Elizabeth Micholovich, BS, MPA, SecureHorizons, a United Healthcare Company, Trumbull, Connecticuten_US
dc.identifier.urihttp://hdl.handle.net/10755/165024-
dc.description.abstractA major Northeast health insurance company recognized an opportunity to reduce complication prevalence and related hospitalizations in patients undergoing cancer treatments using an innovative nurse case management model. This program's purpose is to reduce admissions related to preventable treatment and disease complications. This telephonic care management (TCM) model was designed for patients undergoing active chemotherapy or radiation cancer treatments focusing on those at highest risk of preventable hospitalization. Selection criteria were developed and tested to identify those patients at highest risk. These criteria were used to create a "risk index" based on: diagnosis (excluding childhood malignancies and acute leukemias); disease stage; particular treatments (e.g.: platinum based therapy); caregiver support; and hospital admission history. The risk index was used to stratify the TCM interventionÆs intensity provided to the patient. Preventable hospitalization criteria were developed based on ICD- 9 codes to create a matrix from which hospital claims could be used to identify preventable hospitalizations for nausea, vomiting, diarrhea, dehydration, infection, hematologic abnormalities, respiratory problems, and others. Telephonic nursing assessment tools were created to evaluate signs and symptoms of treatment complications to intervene proactively with patients and their healthcare team to help establish care in the appropriate setting. Program results were assessed by the ability to demonstrate a reduced level of preventable hospital admissions. Admissions were assessed for ICD-9 codes fitting these criteria over time and compared to an unmanaged population. Initial, early, results have shown a positive effect on complication measures: prevalence, admits per 1,000, admits, and average length of stay for managed patients versus those patients who did not receive case management. These outcome parameters represent core goals for oncology nurses. By intervening proactively with patients and their healthcare team and helping support timely care in the appropriate setting, preventable hospitalizations are reduced. The approach and developed tools outlined here can be adapted for use by oncology nurses in other clinical settings to reduce morbidity of cancer and related treatments. Additional analysis will be conducted on this modelÆs impact on enhancing the health care teamÆs care coordination as it relates to preventable hospitalizations, treatment outcomes, and patientsÆ quality of life.en_GB
dc.date.available2011-10-27T12:11:10Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:11:10Z-
dc.conference.date2007en_US
dc.conference.name32nd Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationLas Vegas, Nevada, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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