Annual Report 2017
Department of General Internal Medicine
Toshihiko Doi, Keiji Okinaka, Shigeki Umemura, Takahiro Kogawa, Yusuke Hashimoto, Yasutoshi Kuboki, Tomohumi Miura, Nobuhiko Yamauchi
Introduction
1. Infectious diseases
The mission of the Department of General Internal Medicine (in charge of infectious diseases) is to provide clinical infectious disease consultative service. We also focus on the prevention of healthcare associated infections during cancer care in collaboration with the Office of Infection Control and Prevention.
2. General internal medicine
We aim to develop a collaborative team among departments of internal medicine, that physicians treat patients with systemic therapy (i.e. chemotherapy, targeting agent, hormone therapy, immune checkpoint inhibitor, etc.), so that we can improve patient safety by controlling treatment related adverse event (AE).
Our team and what we do
1. Infectious diseases
We provided 382 infectious disease consultations in this period (Table 1). We also promote the practice of hospital infection control (See section "Office of Infection Control and Prevention").
The number of managed cases in this period
- Positive blood culture cases: 388
- Cases using broad-spectrum antibiotics: 1,022
2. General internal medicine
We focus on the supportive consultation of drug related adverse event (AE) especially of immune checkpoint inhibitor agents. We sometimes experience unexpected immune-related AE and this consultation system is beneficial to solve and recover from severe AEs. Further, our group member has outstanding specialty of each cancer treatment, and we facilitate collaborative treatment and research together.
Table 1. Number of consultations
Research activities
1. Infectious diseases
None
2. General internal medicine
We are performing research of immune-related adverse event in our institution.
Education
1. Infectious diseases
We have provided lectures and bedside teachings on infectious diseases for residents at the National Cancer Center Hospital East (NCCHE), the National Cancer Center Hospital (NCCH), and external hospitals. Okinaka also implemented an antimicrobial stewardship program at the Department of Hematopoietic Stem Cell Transplantation of the NCCH.
In February 2018, we applied for the certification as an approved training facility of the Japanese Association for Infectious Diseases.
2. General internal medicine
Each staff teaches cancer treatment and patient management through bedside learnings and conferences. We also facilitate trainees having opportunities of presentations at an annual conference and writing manuscripts. If indicated, trainees will have the opportunity to prepare clinical research LOI and protocol.
Future prospects
1. Infectious diseases
Consultation services for infectious diseases are now increasingly being recognized as an important part of cancer centers, and some cancer centers have begun to establish a department for infectious diseases. The future goal is to launch fellowship programs for fellows to develop a high level of expertise in order to assume an important role in this field.
2. General internal medicine
We further collaborate with regional institutions to assemble outstanding trainees, and we will develop a tight connection with several huge institutions. We prepare a safety treatment manual of systemic therapy related AEs, and develop safe and cost-effective practice. We plan to have approximately 150 consultations of immune-related AEs.