Ambulatory Oncology Chair Utilisation in Australia: Apilot Study

Abstract

Background Cancer is one of the principal diseases which afflicts Australians, with statistics suggesting that half of all Australians will be diagnosed with some form of cancer by the age of 85. In recent years, the largest increase in demand for enhanced cancer care services has occurred amongst out-patients, rather than in- patients. In order to deliver quality ambulatory oncology care services, it is essential that service providers fully appreciate both the relevant demand issues and the associated supply challenges. Once knowledge in both these areas has been secured, appropriate strategies can be devised through which the implementation of fair, effective, and needs-based services can be ensured. Objectives This study investigates chair utilization in an oncology ambulatory therapy unit in Brisbane, Australia. Specifically, the study examines the relationship between oncology chair utilization and various treatment factors, including the type of cancer, the day of the service, whether the OOS is related to a clinical trial, whether the OOS is SACT or non-SACT, and how the relationship between the trial and the department. Design and methodology In order to achieve the research objectives, this study adopts a retrospective analysis of an administrative dataset (CHARM® Pharmacist at the Princess Alexandra Hospital) related to chair utilization in an ambulatory oncology unit. The relevant data is cleaned by a Metro South Health employee, who has unrestricted access and widespread familiarity with CHARM, ieMR, and Electronic Scheduling Management System (ESM) records. This data cleaning was performed using Microsoft Excel®, wherein different approaches were employed to ensure that the analysed data reflects actual chair utilization in the hospital setting. iii Results The data analysis revealed a number of principal results, to wit: weekdays had a higher incidence of Occasions of Services (OOS) than the weekend, Systemic Anti-Cancer Therapy (SACT) recorded higher levels of OOS than Non-Systemic Cancer Therapy (Non-SACT), and gastrointestinal cancer, lung carcinoma, lymphoma, and breast cancer were the main types of cancer treated in the unit. Since this is the first study to quantify chair utilization in a day oncology setting, the results of this study can be used to inform the future design of a larger multicentre study to enable a comparison to be made between service growth and demand. These findings also have applicability in workforce planning since they can forecast the extent to which capacity should be expanded in order to guarantee effective and responsive cancer care services in ambulatory oncology settings. Based on these findings, it is recommended that future longitudinal studies should be conducted to identify and predict trends in ambulatory oncology cancer care demand. Moreover, the paper recommends a nationwide programme of exploration of ambulatory oncology services in order to arrive at more generalizable conclusions regarding chair utilization in ambulatory oncology care centres.