Title: Implementation of intensive care unit strategy for oncology
1(No Transcript)
2Implementation of intensive care unit strategy
for oncology
Cancer patients admitted to an emergency or
intensive care unit (ICU) have some critical
requirement of basic care needs because of their
unknown illness time-point in the treatment plan
and treatment-related deadliness resulting to an
organ damage, hemodynamic infection or blood
contamination. Over the past two decades,
therapeutic advances have reshaped not just
medical approach but also the way a hospital
billing and coding tasks take place. An
Oncologists way to deal with patients with
tumors, rethinking care settings and considering
more aggressive treatments is the need of the
hour. Subsequently, patients with oncology
problems frequently require extra time in an
intensive care unit. As care and procedures for
these patients keep on advancing, so should the
knowledge base and capabilities of attendants
from both the critical care and oncology
facilities. Generally, these two medical
specialties performed independently, but this led
to in-house staffers having to handle both
treatment service and the administrative services
like claims filing and also oncology medical
billing and coding.
3Implementation of intensive care unit strategy
for oncology
ICU for Oncology Since the beginning of
intensive care as a formal health programme in
the late 1950's, we have seen rapid
specialization in various kinds of ICUs to suit
advancing life-supporting technologies and novel
treatments. One of the first reported critical
care units was produced at the Johns Hopkins
Hospital in the 1920s by Walter Dandy, which
housed three beds for post-operative
neurosurgical patients. Early ICUs were built for
close checking by doctors and medical attendants
who remained near the patient to respond
emergency and provide care. As ICU facilities
advanced it concentrated on providing newly
created supportive measures incorporating
developments in mechanical ventilation, renal
substitution treatment, continued hemodynamic
observing, and extracorporeal support. From the
development of the ICU came the requirement for
devoted oncology specialists. Experts during the
time brought change to incorporate more
patient-centered care units and the
acknowledgment that high-power staffing delivered
the best care to patients. With the objective of
enhancing results, specialty ICUs started.
4Implementation of intensive care unit strategy
for oncology
Cardiology and Neurology are two clinical
specialties that truly have and had the solitary
ICUs. These days, other specific ICUs exist
tailored to injury, consumes, organ transplant
and cardiothoracic medical procedures. In any
case, would we say we are sure that patients have
better results since they are dealt with in a
specific ICU? Furthermore, in the event that we
see an added advantage from ICUs organized by
specialty, do we have to think about the
development of specific ICUs for cancer patients,
especially oncology? Do patients in ICUs at
cancer facilities centers perform better than
those at general hospitals? In a recently
published article in the Journal of Clinical
Oncology, it is described how ICU organizational
characteristics might affect clinical outcomes
and resource utilization in patients with cancer.
In ORCHESTRA (name of the research paper), the
authors retrospectively reviewed 10,000 patients
admitted to 75 ICUs. Of those, 55 were in general
hospitals and 20 were in cancer centers. The
research writers found that the presence of
clinical pharmacists in the ICU, the presence of
ICU protocols, and daily meetings between
oncologists and experts were associated with
lower hospital mortality even after adjustment
for hospital case volume. Protocols and daily
meetings were also associated with more efficient
resource utilization.
5Implementation of intensive care unit strategy
for oncology
What is the Conclusion? We as specialty oncology
medical billers and coders support the need for
cancer-specific guidelines for ICU admission and
protocols for care that can be implemented in any
ICU, general or cancer-specific. If future
studies show the added-value of an oncological
ICU, then further evaluation should be done,
based on regional cancer prevalence and
geographic resources, to most effectively
transfer those cancer patients needing ICU level
of care to a center with the infrastructure of a
dedicated high intensity staffed oncological
ICU. About Medical Billers and Coders Medical
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