Year of Publication

2018

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Debbie Hampton

Clinical Mentor

Cheryl Martin

Committee Member

Dr. Kristin Pickerell

Abstract

Purpose: The purpose of this project was to evaluate outcomes of implementation of the Norton Cancer Institute (NCI) Prompt Care Clinics (PCCs), to include number of emergency room (ER) visits and number of inpatient admissions. A second purpose of the study was to identify presenting symptoms for patients seen in the NCI PCCs and compare the average charge per case for patients seen in the ER or NCI PCCs with the same diagnosis.

Methods: This study employed a pre-post implementation retrospective review of NCI patient electronic medical records (EPIC) to examine the effectiveness of the NCI PCCs on ER visits, inpatient admissions, and average charge per case for patients seen in the ER and NCI PCC.

Results: Prior to implementation of the PCCs, 5.2% of patients went to the ER, 16.6% were admitted, and 78.2% were seen at one of the NCI facilities. Post implementation, 3.6% of patients went to the ER, 17.5% were admitted, 21.8% were seen at NCI Offices, and 57.1% went to the NCI PCCs. Of the 280 encounters seen at NCI Offices or the NCI PCC’s, the most frequent symptoms were nausea (13%), followed by emesis (13%), fever (11%), dehydration (9%), diarrhea (8%), anemia (3%), and pneumonia (< 1%). There was a significant difference in charges for the NCI PCCs versus the ER visits for patients seen with dehydration (p=.047), diarrhea (p=.013), and fever (p=.014).

Conclusion: During the six-month study period, there was no significant difference in number of ER visits or inpatient admissions over time but cost savings were noted for patients presenting with specific symptoms.

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