6580 - Inpatient Hematology and Oncology Rehabilitation.

Document Type

Article

Publication Date

6-2017

Abstract

Functional decline in cancer patients impacts quality of life and overall survival. Increasing attention has been focused on cancer rehabilitation in survivors, largely in the outpatient setting. Beaumont Health System has shifted its focus to include the acute setting by developing an inpatient cancer rehabilitation unit (IPCR) to improve the comprehensive care of patients. Methods: We retrospectively reviewed the patients admitted to IPCR from January 1 - December 31, 2016 for the following: demographics, length of stay (LOS), function independence measure (FIM) gain and efficiency, discharge location, and primary tumor type. Results: IPCR had 117 inpatient admissions; 98 (83.7%) were solid malignancies while 19 (16.3%) were benign hematological disorders and hematological malignancies. Of the 98 patients with solid malignancies, 22 (22.4%) patients had breast cancer, 22 (22.4%) had gastrointestinal cancers, 5 (5.1%) had gynecological cancers, 23 (23.5%) had lung cancer, 8 (8.2%) had CNS malignancies, 11 (11.2%) had other cancers, and 7 (7.2%) had prostate cancer with 81.6% of patients having metastatic disease. Among the hematological malignancies, lymphoma was diagnosed in 11 (57.9%) patients while 3 (15.9%) each had multiple myeloma and leukemia. The mean age of the patients was 68 years and 59% were female. The average LOS was 8.6 days. The mean admission total FIM was 66.7 ±12.8 and discharge total FIM was 87.3 ±16.1. The total improvement in FIM was 20.6 ±13.8 with FIM efficiency of 2.9. There were 21 (18%) patients transferred back to acute care units for decompensation, 7 (6%) went to subacute rehabilitation, 1 (0.85%) went to hospice while 87 (74.3%) were discharge to their homes upon completion of IPCR. Conclusions: Our focused rehabilitation was able to decrease the LOS, well above the 90th percentile Center for Medicare and Medicaid Services (CMS) benchmark and other prior studies, as well as enable patients to safely return home with improved FIM. Creating an IPCR unit proved to be beneficial, allowing for more comprehensive and individualized care, even in the setting of advanced malignancies.

Comments

American Society of Clinical Oncology, Chicago, IL, June 2-6, 2017.

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