CARE CLINIC INNOVATIONS IN ONCOLOGY URGENT CARE
Presenters:
Kasey Bowden, MSN, FNP, AG-ACNP, Rebecca Youngling, RN
Conference:
2024 Meeting of the Oncology Nursing Society (ONS) Metro Denver Chapter
At the 2024 Meeting of the Oncology Nursing Society (ONS) Metro Denver Chapter, Registered Nurses Kasey Bowden and Rebecca Youngling presented an overview of the CARE Clinic at the University of Colorado Cancer Center, a multidisciplinary initiative aimed at enhancing the quality, value, and patient experience of cancer care through advanced symptom management and urgent care services. Bowden and Youngling underscored the role of the clinic in bridging a critical gap between the rapid pace of scientific advancement in oncology and the healthcare system’s ability to address patients’ needs in the real-world. Given the rise in new cancer diagnoses due to an aging population, the burden of cancer and its aftermath on healthcare systems is growing, and the CARE Clinic offers a proactive, patient-centered solution aimed at reducing hospitalizations and improving overall well-being for patients living with and after cancer.
Bowden noted that, while cancer mortality rates have decreased by 29% between 1991 and 2017, cancer patients are now living longer and encountering new challenges, such as increased symptom burdens, financial strains, and healthcare disparities. Acute care episodes, including hospitalizations and emergency department (ED) visits, remain prevalent among cancer patients, with chemotherapy patients averaging one hospitalization and two ED visits per year, often due to treatment toxicities. These episodes can negatively impact quality of life, delay treatment, and increase healthcare costs. The CARE Clinic was developed to address these gaps and improve patient outcomes by preventing unnecessary acute care interventions.
The CARE Clinic offers a comprehensive suite of services specifically tailored to the needs of oncology patients, including intravenous (IV) medications, blood product transfusions, electrolyte repletion, laboratory testing, and same-day imaging. It also provides specialized procedures, such as paracentesis and thoracentesis, and urgent palliative care to support patients experiencing acute symptoms. By offering rapid, effective interventions in a dedicated clinic setting, the CARE Clinic significantly reduces the need for emergency care. Operating seven days a week, the clinic is staffed by hospital medicine providers, oncology nurses, and medical assistants, ensuring continuity of care and swift responses to patients’ needs.
Youngling emphasized the central role of nursing within the CARE Clinic model, describing nurse-driven initiatives that enhance patient support. For example, nurses conduct initial consultations with patients starting anti-cancer therapy, introducing them to the clinic’s services and reducing the likelihood of ED visits. Nurses have also collaborated with radiology to guarantee urgent same-day scans for oncology patients, further streamlining care coordination. Through its urgent palliative care program, the clinic provides timely support to patients with acute declines, which reduces unnecessary hospitalizations and improves the delivery of end-of-life care.
The presenters emphasized the clinic’s overall impact as evidenced by several key outcomes. They noted that, since its inception, the CARE Clinic has achieved a 50% reduction in 30-day preventable ED visits and has received high patient satisfaction ratings. Patient feedback has been overwhelmingly positive, with many expressing gratitude for the clinic’s availability and responsiveness. In addition to clinical benefits, the CARE Clinic has demonstrated financial advantages, with available data indicating that visits to the clinic cost 33-50% less than equivalent ED visits, underscoring the model’s value for both patients and the healthcare system overall.
Bowden and Youngling attribute the CARE Clinic’s success to its culture of collaboration, leadership, and staff engagement. The clinic fosters a teamwork-based approach in which providers, nurses, and medical assistants work closely and without hierarchical barriers, promoting mutual respect and support. The staff members are empowered to operate at the top of their scope of practice, with their involvement in workflow improvements helping to maintain sustained engagement. Leadership also prioritizes staff well-being by organizing events such as team outings and celebrations, fostering a positive and supportive work environment.
The presenters noted that the CARE Clinic model represents a reimagining of oncology care to meet the evolving needs of patients. Bowden and Youngling emphasized that this approach not only alleviates patient suffering, but also contributes to building sustainable healthcare systems that benefit both patients and providers. The success of the CARE Clinic serves as a potential blueprint for other cancer centers, demonstrating that urgent and acute care models tailored to oncology patients can improve outcomes and reduce costs. The presenters concluded by highlighting the vital role of nursing leadership in identifying gaps and driving innovation in cancer care, with many of the clinic’s initiatives emerging from frontline nursing staff.
Speaker Disclosure Information: Bowden and Youngling reported no disclosures for this presentation.
You can see the full CARE Clinic presentation from the 2024 Meeting of the Oncology Nursing Society (ONS) Metro Denver Chapter here: