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Annual Report 2019

Outpatient Treatment Center

Kenji Tamura, Shunsuke Kondo, Satoru Iwasa, Dai Maruyama, Yasuji Miyakita, Masanaka Sugiyama, Aiko Maejima, Dai Ogata, Masatoshi Sekiguchi, Toru Akagi, Ryoko Udagawa, Kimihiko Kawamura, Masae Hiramatsu, Mihoko Asanabe, Mayu Harada, Saori Takiyama, Noriko Mori

Introduction

 The Outpatients Treatment Center deals with all kinds of cancer patients who have received chemotherapies as outpatients. Our mission is to provide safe, comfortable and high-quality chemotherapy. Several groups collaborate to ensure the best chemotherapy, consisting of medical oncologists, nurses, pharmacists, medical social workers (MSWs) and clinical research coordinators (CRCs). Our visions are: 1) to provide evidenced-based medicine (EBM) and develop novel anti-cancer drugs; 2) to provide safe and efficient treatments, and management of adverse events; and 3) to create a comfortable environment, and to maintain the quality of life of the patients.

The Team and What We Do

1) Setup

 Our division consists of one director (K.T.), and another 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 Dept. Clinical Laboratory, 27 nurses, two pharmacists, and two to three reception staff.

 Our division consists of one director (K.T.), and another 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 Dept. Clinical Laboratory, 27 nurses, two pharmacists, and two to three reception staff.

2) Performance

 We set up a second Outpatients Treatment Center at the beginning of 2015. There are 30 beds in the 1st Outpatients Treatment Center and 26 in the 2nd Outpatients Treatment Center (total: 56). We also have 6 beds for general infusions or blood transfusions.

 In 2019, Outpatients Treatment Center supported at 44,802 patients who received anticancer drugs (Figure 1). The breakdown by department was Breast and Medical Oncology (n=14,076), Gastrointestinal Medical Oncology (n=9,180), Hepatobiliary and Pancreatic Oncology (n=6,416), Thoracic Oncology (n=5,890), Hematology (n=3,046) and other departments (n=6,194) (Figure 2). General infusions, general intramuscular or subcutaneous injections, blood transfusions, bone marrow punctures, lumbar punctures, intraperitoneal or chest drainage and blood gas analyses were conducted in the center.

Figure 1
Figure 1

Figure 1
Figure 1

Figure 2
Figure 2

Figure 2
Figure 2

3) Staff Meeting

 The monthly staff meeting is held on the second Tuesday, 16:30-17:30, every month with the participation of physicians and nurses who are the main members in the center. The steering committee is held on the third Thursday every month.

4) Hotline & Conferences

 We have a telephone consultation service (hotline) for outpatients who have received chemotherapy. We have around hotline 120 cases per month. A case conference especially about the hotline is held monthly on a Tuesday with the participation of multidisciplinary specialists, including medical oncologists, nurses, and pharmacists.

Research activities

  • Operation of early morning frames
  • Support for working in investigational drugs including PK study.
  • Safety management of allergic reaction and infusion reactions
  • Telephone hotline for emergencies for outpatients who receive chemotherapy.
  • Monitoring adverse events of immuno check point 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 for institutions outside the NCC, for medical oncologists, nurses, pharmacists and MSWs in designed hospitals for cancer treatment in each prefecture.

Future prospects

 We are going to run more early morning frames In the Treatment Center and continue proposing a model for more outpatient clinical trials. We aim to shorten waiting times, to achieve smooth administration of novel molecular targeted drugs for outpatients, to put into practice multidisciplinary care, and to create a comfortable environment for cancer patients who receive chemotherapy in the Outpatient Treatment Center. Moreover, we strive to work with higher labor productivity and to create a rewarding workplace in the Outpatient Treatment Center of the National Cancer Center Hospital.