Care for Cancer Patients When They Need It Most

When cancer pain, symptoms, or side effects get worse late in the day, Allegheny Health Network (AHN) patients can now visit the After Hours Oncology Clinic. They can skip the trip to the emergency room (ER). This helps protect patients with compromised immune systems. The clinic also costs less than the ER and has shorter wait times. Cancer care after sundown is living proof that we put patients first.

The first of its kind in western Pennsylvania, the After Hours Oncology Clinic offers specialized care Monday through Friday from 3 to 7 p.m. This is when cancer patients need it most. It is designed to provide timely care in an appropriate setting to meet their unique needs. Trained clinicians also take calls.

Convenient for caregivers

It’s especially helpful to caregivers who work during the day, according to Kara Keast. She has already taken her elderly father, Steve Krynak, to the clinic several times. He has been receiving chemotherapy for lymphoma. The clinic treated him for dehydration.

“We wanted to be able to provide care for our patients when they don't feel well. As other urgent care providers have discovered, that often occurs when traditional offices are closed,” said Clinical Coordinator Eileen Milakovic, RN, BSN, MA, OCN. “It is also more convenient for working patients and caregivers who may be the transportation provider.”

Oncology specialists

Located at West Penn Hospital’s Mellon Pavilion, the After Hours Oncology Clinic hosts a staff capable of helping patients with all types of cancer. The clinic is staffed by a certified registered nurse practitioner, a registered nurse, and a medical assistant. They are all trained in oncology and work under the direction of an oncologist.

“Unfortunately, our patients are susceptible to the issues that bring many people to an emergency room. These issues (infections, pneumonia, etc.) can literally be life-threatening to our oncology patients,” said Milakovic. “Also, our wait time is essentially non-existent. Patients are seen immediately, and there is no ER copay for them.”

Providing relief from side effects

Side effects from cancer treatments can significantly decrease the quality of life for patients. Many will visit an ER at some point during their treatment or recovery. In 2014, western Pennsylvania emergency rooms logged nearly 3,000 visits from cancer patients, according to David Parda, MD, Chair, Allegheny Health Network Cancer Institute.

Cancer patients’ symptoms may include:

  • Pain
  • Fever
  • Fatigue
  • Upper respiratory infections
  • Cough
  • Painful mouth sores that make it difficult to eat
  • Nausea
  • Vomiting
  • Diarrhea
  • Constipation
  • Dehydration
  • Rashes

“It helped us stay out of the ER,” said Keast. “Eileen went out of her way to help us. They gave him [my father] fluids. It’s a long process.”

Patients should call (412) 770-3571 before coming to the clinic. An oncology clinician will ask questions to determine whether or not the symptoms can be managed at home. If a patient has life-threatening symptoms such as chest pain or shortness of breath, they should go straight to an ER.

When Keast calls, Eileen’s team springs into action. They have gotten to know her father.

“He gets treated like a king,” remarked Keast. “They give him sandwiches, a drink, and a big reclining chair. They always ask if he needs anything. They are very caring.”

Healthcare @ Home

Care for patients doesn’t end with a visit to the After Hours Oncology Clinic. Clinic caregivers make follow-up calls within 48 hours to check on the patients. They also connect patients with services to ensure a smooth transition of care, such as AHN’s Healthcare @ Home program. It aims to help improve patients’ quality of life by working with patients and families to:

  • Understand treatment choices and develop an individualized plan
  • Coordinate treatments from different caregivers
  • Plan for post-hospital care at home or an inpatient facility
  • Make patients comfortable at home with palliative care

Coordinated care for AHN patients

The After Hours Oncology Clinic is open only to patients being treated for cancer at Allegheny Health Network locations. This ensures clinicians have access to the patients’ oncologists who know them best. Through the use of electronic health record software, they have access to medical records no matter where a patient’s doctor’s office is located.

“We have access to all of the same equipment that is available in the oncology clinic during the day, so we are not disadvantaged by working in the evening,” said Milakovic.

“We can research issues for a patient who is on the way to see us. We don't have to spend precious time having them recall and provide their whole history. We know what treatments they have had and when, and what their previous test results have been.”

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