Annual Report 2017
Outpatient Treatment Center
Kenji Tamura, Shunsuke Kondo, Kazuki Sudo, Hidehito Horinouchi, Satoru Iwasa, Dai Maruyama, Yasuji Miyakita, Tadashi Kumamoto, Tomohiko Hara, Shin Tsutsumida, Masatoshi Sekiguchi, Toru Akagi, Tomomi Sano, Miho Kurihara, Chiemi Kojima, Hiroe Ohara, Mayu Harada, Kimihiko Kawamura, Koichi Ishikawa
Introduction
The Outpatient Treatment Center deals with all kinds of cancer patients who have received chemotherapies as an outpatient style. Our mission is to provide safe, comfortable, and high quality of standard chemotherapies. Several groups collaborate to ensure the best chemotherapies, consisting of medical oncologists, nurses, pharmacists, medical social workers (MSWs) and clinical research coordinators (CRCs). Our visions are as follows:
1) To provide an evidence-based medicine (EBM), and to develop novel anti-cancer drugs
2) To provide safe and efficient treatments, and to ensure the management of adverse events
3) To create a comfortable environment, and to maintain the quality of life (QOL) of patients
Our team and what we do
1. Setup
The Outpatient Treatment Center consists of one director (K.T.), and other nine medical doctors, one deputy nurse director, one nurse manager, two deputy nurse managers, one deputy drug director, one chief pharmacist, one dispensing chief, one chief engineer of the Clinical Laboratories Division, 24 nurses, three pharmacists, two to three reception staff.
2. Performance
We set up the second Outpatient Treatment Center in the beginning of 2015. There are 30 beds in the first Outpatients Treatment Center and 26 in the second Outpatients Treatment Center (total 56). We also have six beds for general infusions or blood transfusions.
In 2017, the Outpatient Treatment Center supported 38,754 patients who received anticancer drugs (Figure 1). The breakdown by department was Breast and Medical Oncology (n=13,842), Gastrointestinal Medical Oncology (n=7,510), Hepatobiliary and Pancreatic Oncology (n=4,553), Thoracic Oncology (n=4,117), Hematology (n=3,388) and other departments
(n=5,344) (Figure 2). General infusions, general intramuscular or subcutaneous injections, blood transfusions, bone marrow puncture, lumbar puncture, intraperitoneal or chest drainage, and blood gas analyses were conducted in our center.
3. Staff Meeting
The monthly staff meeting is held on the second Tuesday of every month at 16:30-17:30 with the participation of physicians and nurses who are main members of our center. The steering committee is held on the third Thursday of every month.
4. Hot line & Conference
We conducted a telephone consultation service (Hot line) for outpatients who have received chemotherapies. We have around 120 Hot line cases per month. A case conference, especially about the Hot line, is held monthly on a Tuesday with the participation of multidisciplinary specialists, including medical oncologists, nurses, and pharmacists.
Research activities
*Operation of an early morning frame
*Support for circumstance of working in investigational drug including pharmacokinetic (PK) study
*Safety management of allergic reaction and infusion reaction
*Telephone hot line for emergencies for outpatients who receive chemotherapies
*Monitoring adverse events of immune checkpoint inhibitors
*Communication with other departments
Education
We provide educational opportunities for multidisciplinary specialists, including medical oncologists, nurses, and pharmacists. We also provide an educational program directed outside the hospital from the National Cancer Center (NCC), for medical oncologists, nurses, pharmacists and MSWs in specially designed hospitals for cancer treatment in each prefecture.
Future prospects
We are going to run more early morning frames. The Outpatient Treatment Center continues in proposing a model for more clinical trials in an outpatient style. We aim to shorten waiting time, undertake the smooth administration of novel molecular targeted drugs for outpatients, put multidisciplinary care into practice, and make comfortable environment for cancer patients who received chemotherapies in the Outpatient Treatment Center.
