Dr. David Rizzieri

When cancer patients need care for easily treatable side effects from chemotherapy, they prefer to avoid the emergency room for non-emergencies.

How do we know this? Because our patients at Novant Health told us in surveys that staying out of the ER for simple problems was a top priority.

Emergency room wait times can be lengthy and unnecessarily expose our immunocompromised patients to other sick patients.

So, our emergency room and inpatient teams worked together on an initiative we’re calling “ER Bypass,” a program that allows cancer patients to get the oncology care they need, faster.

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Novant Health has recently started reserving space in its patient oncology specialty floor at its Presbyterian Medical Center. The floor is staffed, around the clock, by a team of oncology-trained nurses, providers and pharmacists.

Research indicates that nearly 80% of visits to the emergency room for patients on active chemotherapy may be avoided. Typical symptoms include relatively routine issues such as nausea, pain, vomiting, diarrhea, and fever when a patient’s blood count is low. When patients on active chemotherapy call into our triage line at night, they now have the option to be seen immediately by a nurse specialist in oncology and by a physician who is onsite for the cancer service overnight. Half of those patients can go home a few hours later rather than remain in-patient.

They can also get initial antibiotics, and then be seen in our outpatient daily clinic, so they don’t have to be admitted to the hospital for prolonged periods for those IV antibiotics. ER Bypass allows us to provide rapid, efficient, seamless care for those patients. That’s what we’ve rolled out in our current pilot, and based on what we’ve seen work, we’re going to expand the program to our other markets across the Novant Health system.

This concept is starting to catch on elsewhere, but it’s not commonplace. That’s because it requires a commitment from health systems that, as a whole, are hard-pressed to hold a bed open at night.

And to be sure, this requires flexibility on the part of our dedicated nurses, nocturnists, pharmacy and other support staff. But our teams are here for the patients. It’s what we do.

There’s also the issue of time and money for patients. ER bypass will also help patients avoid ER charges that are typically higher. Frankly, who wouldn’t want to receive better care more efficiently and save money?

All of this is consistent with our mission to improve the health of our community, one patient at a time. We have a commitment to offer an appointment within three days of a cancer care referral coming to us. Access is everything to patients. They want to know they’ll be taken care of. And referring physicians want to know they’ve sent their patients to the right team.

As we continue to hone our long-term strategy for Novant Health, these are the principles that will guide us:

  • Keeping patient needs front and center with a focus on offering an exceptional experience that is further enhanced with specialization.
  • Providing multi-disciplinary care with a team of committed specialists who can provide top care from every angle.
  • Harnessing the most novel therapies and clinical research opportunities available.

In the end, of course, it’s what the team brings to the patient that makes the biggest difference. At Novant Health, we strive every day to walk the talk of patient-centric care. We start by listening, then move forward with compassion and commitment.

David Rizzieri, MD, CPE is the Senior Vice President and System Physician Executive for the Novant Health Cancer Institute. He holds the Agnes B. and Edward I. Weisiger Endowed Chair for Cancer Research.