Patients Benefit from Wilmot Cancer Center & Highland Hospital Connection
As the census at UR Medicine Wilmot Cancer Center continued to grow, inpatient units were routinely stretched to capacity and roughly seven to 10 oncology patients a day would have to be admitted to the medical/surgical units at Strong. Discussions on better ways to care for these patients resulted in the creation of a medical oncology unit at Highland last summer.
More than 470 Wilmot Cancer Center patients have been admitted to Highland since July 1, 2018. Currently, Wilmot patients use 10-12 beds daily on East 5. “This collaboration is an ideal co-management model,” says Megan Baumgart, M.D., URMC Director of Inpatient Operation for the Solid Tumor Oncology Program in the Division of Hematology/Oncology. “Patients are happy with their care, and having the beds available at Highland has had a major impact not only on decompressing Wilmot’s inpatient units, but also the medical/surgical units across Strong.”
The unit focuses on geriatric/medical oncology patients, although others are admitted as well. “This was a welcome initiative for us and fits with our clinical expertise,” says Corey Romesser, M.D., Geriatric Director of Inpatient Services at Highland who serves as the unit’s medical director. “Most of us in the unit at Highland are geriatric and/or palliative care certified. Working in conjunction with medical oncology, we are offering an excellent patient experience.” Overall rating in patient satisfaction scores on the unit have increased since the initiative began from 82.1 (FY18) to 83.3 (FYTD19).
This arrangement has also helped to ensure that patients are in the correct location for care with staff who have expertise in oncology. “We enjoy working with the team at Highland,” said Dr. Baumgart. “They have great expertise in geriatric and palliative care, which many of our patients need. We value their skills in caring for these medically complex patients.”
Use of the beds at Highland have helped decompress affected med/surg units at Strong which has been especially helpful since Strong had an average daily occupancy of 105 percent from January to April. In addition, the Wilmot at Highland arrangement has also reduced by 10 percent the average time oncology patients had to wait in the ED for a bed once the decision to admit was made. It has also reduced the number of oncology patients boarding in the ED and the number of Surgical Oncology patients boarding in the PACU at Strong.
East 5, a unit already designated for gynecology oncology patients, was an easy choice for the Wilmot/Highland partnership. “This unit was already staffed with highly skilled nurses who were experienced in compassionate cancer care,” said Dr. Romesser. “And the collaboration with nursing, social workers, care coordinators, and physicians has made this an easy transition. Co-management of patients is a hallmark for Highland, which has been nationally recognized for care of geriatric fracture patients, a collaborative effort with orthopaedics and geriatrics.”
Wilmot’s Patient Access Specialist (PAS) plays a critical role in ensuring the success of Wilmot at Highland. Joyce Rampello, B.S., R.N., currently holds the role, and has strong oncology expertise and is dedicated to streamlining admissions through Wilmot. Rampello interfaces with patients and providers across UR Medicine, including regional locations, the admitting officers at both Strong and Highland, the transfer center, and staff at the individual units at both institutions. The PAS debuted last spring, and has helped decrease the number of oncology patients having to go to the ED before unplanned or urgent admissions. Since April 2018, more than 330 patients have been diverted directly to beds at Wilmot and Highland instead of going to the ED.