Annual Report 2023

Outpatient Treatment Center

Yoshitaka Honma, Suguru Fukuhara, Yuta Maruki, Yuki Shinno, Shosuke Kita, Hidekazu Hirano, Eiji Nakano, Jun Sato, Shunsuke Yanagisawa, Kiyotaka Isobe, Tomohisa Asano, Akiko Kubo, Ryoko Udagawa, Mihoko Asanabe, Emi Fujii, Miho Yano, Yuko Togashi, Shigeki Yamazaki

Introduction

 The Outpatient Treatment Center handles various types of chemotherapies on an outpatient basis. Our mission is to provide safe and relief treatment to cancer patients and their families with highly qualified supportive care based on the abundant treatment experience of every staff member, including medical oncologists, nurses, pharmacists, medical social workers, and clinical research coordinators. Moreover, we polish our skills to launch outpatient treatment using novel anti-cancer drugs quickly and safely through the experience of pivotal clinical trials conducted in our institute.

The Team and What We Do

• Organizational structure

 The members belonging to our center consist of one managing director (Y.H., person in charge), three vice-directors, and six staff for physicians; one supervised director, one managing director, three vice-directors, and 29 staff for nurses; one supervised director, one managing director, and one director engaging drug dispense for pharmacists. Additionally, there is one laboratory technician and 3-5 reception staff.

• Performance

 We have two centers and 73 treatment booths: 38 in the 1st center and 35 in the 2nd center. A total of 49,956 patients received chemotherapy at the Outpatient Treatment Center in 2023 (Figure 1). The central departments accessing our center were Medical Oncology, Head and Neck Esophageal Medical Oncology, Gastrointestinal Medical Oncology, Hepatobiliary and Pancreatic Oncology, Thoracic Oncology, Hematology, Dermatologic Oncology, and Experimental Therapeutics. Our center also supports drip infusions, intramuscular or subcutaneous injections, blood transfusion, bone marrow aspiration, lumbar puncture, chest or abdominal drainage, and arterial blood sampling.

• Staff meeting

 We hold the staff meeting on the 2nd Thursday with the participation of the core members and steering committee of the Outpatient Treatment Center on the 3rd Thursday every month. In these meetings, we discuss operational problems, improvement plans, new approaches, and the future direction of our center.

• Telecare service and multidisciplinary conference

 We provide a telephone consultation service (Telecare) for patients treated with chemotherapy on an outpatient basis and we have approximately 100 cases of access to the service per month. A multidisciplinary conference is also held every month to conduct an in-depth review of the solutions to complicated cases with various medical staff.

Research Activities

• Expansion of treatment slots offered early in the morning for efficient center operation
• Support for circumstances of working in the clinical trial, including the PK/PD study
• Securing a system for the safe management of allergic and infusion reactions
• Telecare for the triage of patients suffering from adverse events caused by chemotherapy
• Monitoring and supportive care of adverse events induced by novel molecular targeted therapy or immune checkpoint inhibitors
• Communication and collaboration with the multidisciplinary medical staff

Clinical Trials

• Our team has started the patient’s interview using the PRO-CTCAE or the health record application before the examination of the attending physician. Patients’ conditions can be shared multidisciplinarily by collecting information using a tablet device, which leads to providing high-quality care to patients and their families effectively. This attempt is currently being tested on limited patients, and the preparation is underway to make it available to more patients.
• Our team also focuses on holistic care for patients with the Adolescent and Young Adult (AYA) generation. We continuously screen for a wide range of social problems specific to this population using a digital questionnaire during the treatment. This data is also shared multidisciplinarily, and we attempt to provide timely holistic care.

Education

 We provide educational opportunities such as study meetings or lectures to the center staff from the multidisciplinary specialists inside and outside the National Cancer Center Hospital.

Future Prospects

 As we have done up to now, the Outpatient Treatment Center will continue to provide high-quality treatment through abundant clinical practice experience and supportive care based on multidisciplinary collaboration. Moreover, we polish our skills to launch outpatient treatment using novel anti-cancer drugs quickly and safely through the experience of pivotal clinical trials as a leading cancer center in Japan. As a future perspective, we plan to utilize the multiple data extracted from the in-hospital integrated database to achieve a more efficient center operation and increase the number of outpatient treatments.