Annual Report 2019
Supportive Care Development Center
Narikazu Boku, Emi Fujii, Naoko Inamura, Shiori Yamaoka, Asuka Kijima, Mami Akutsu, Momoko Takahashi, Chihoko Nemoto, Chihiro Dei, Kurumi Jyo, Akiko Mizuta, Erika Onuki, Naoko Arii, Meiko Mazaki, Yasuko Abiru, Kiyomi Kawase, Miwako Saito, Hitomi Ninomiya, Odaira Mikiko, Sayaka Kurata
Introduction
During the treatment and management of cancer patients, there are various unmet needs which cannot be solved by each patient just visiting a doctor; it is generally recognized that taking a team approach to these problems is very important. In September 2016, the Supportive Care Development Center was opened as the team medicine base in the National Cancer Center Hospital. We are supplying many kinds of support to not only patients but also to their families in collaboration with doctors and other team members consisting of many dedicated professionals.
The Team and What We Do
The number of patients and their families visiting our department has been increasing gradually, reaching a peak of 153.1/day in January 2020 (thereafter it decreased slightly due to the coronavirus pandemic), when the monthly number of users of each standing program was as follows: Preoperative Management (703), Nurse Consultation (103), Consultation Counselling and Support Center (378), Pharmacist Consultation (334), Nutritionist Consultation (792), Rehabilitation (43), Appearance Center (22), Palliative Medicine (174), Psycho-Oncology (312), Anesthesiology (413), Lymphedema Management (81) and Physicians Referral Service Office (53). We have regular classes for Adolescent & Young Adults, Pain Care, Support for Children and Parents, Nutrition, Anti-Cancer Agents, Pancreato-Biliary Cancer, Body Image for Breast Cancer Patients, Relaxation, and Lymphedema Management. In Preoperative Management, we have started to manage surgery of gynecological malignancy, and have expanded the activity including psychological oncology for esophageal and head & neck cancer patients who have risks for delirium and pre-operative chemotherapy for pancreatic cancer patients. Group instruction in Preoperative Management and interview sheets for Nurse Consultation have succeeded in shortening the meeting time.
Research activities
- Based on the experiences of Nurse Consultation that 6/86 (7%) patients consulted the Psycho-Oncology Division, we established a check sheet to identify patients requiring psychological support/intervention.
- In Preoperative Management, we classified the problems of elderly patients into 8 categories.
- In the Adolescent & Young Adult (AYA) classes, we identified the problems of AYA patients and their families.
The Team and What We Do
Considering that we should be aware of our research for developing supportive care and be a model for cancer care staff in other hospitals, we continue to revise our daily duty work using the PDCA (plan-do-check-act) cycle. Under the social and medical conditions of the coronavirus pandemic, we are establishing new methods for group/personal consultation and instruction using web-based systems.
Clinical trials
The protocol of retrospective studies for evaluating the clinical activities of the Supportive Care Development Center was approved at the end of 2017. We conducted several retrospective studies, as described above.
Education
New staff and nurses from hospital wards participate in the Nurse Consultation and Preoperative Management programs and receive on-the-job training under the supervision of the staff of the Supportive Care Development Center.
Future prospects
We continuously try to improve and newly develop our programs and to be a model for other hospitals taking care of cancer patients, and promote collaboration with the patients’ regional medical facilities.
Figure 1. Activity of each program at the Supportive Care Development Center (number of patients)