Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

Reducing emergency presentation and Length of Stay (LoS) through an ambulatory paracentesis pathway for malignant ascites via the Rapid Access Clinic Expansion (RACE) (146569)

Martina O'Neill 1 , Kacy J Ringshaw 1 , Cassandra J Mazza 1 2 , Ebony V Hetherington 1 , Marius Pezard-Snell 1 , Connor Stewart 3 , Rebecca Crust 1 , Georgia Parker 1 , Jessica Garrett 1 , Michael J Allen 3 4 , Cassie Turner 3 4 5 , Bryan A Chan 3 4 5
  1. Cancer Care Services, Sunshine Coast University Hospital and Health Service, Birtinya, QLD, Australia
  2. Frazer Institute, Faculty of Health Medicine and Behavioural Sciences, The University of Queensland, Brisbane, Qld, Australia
  3. School of Medicine and Dentistry, Griffith University, Sunshine Coast, Qld, Australia
  4. Department of Medical Oncology, Sunshine Coast University Hospital, Birtinya, Qld, Australia
  5. School of Medicine, The University of Queensland, Brisbane, Qld, Australia

Introduction 

Malignant ascites commonly results in recurrent emergency presentations and prolonged inpatient admissions for abdominal paracentesis, contributing to increased health service utilisation and patient burden. Ambulatory care models may provide a timely patient-centric alternative to traditional inpatient pathways. 

Aim 

To evaluate the impact of an ambulatory Rapid Access Clinic Expansion (RACE) paracentesis pathway on hospital utilisation and patient-centred care outcomes compared with the current inpatient model. 

Methods 

A retrospective quality improvement project evaluating oncology patients requiring paracentesis before and after implementation of the ambulatory RACE paracentesis pathway. Data extracted from electronic medical records included: length of stay (LoS), Emergency Department (ED) utilisation, and procedural outcomes.  

Results 

Patients managed via RACE achieved complete ED avoidance and significantly reduced mean LoS compared with the inpatient cohort (0.85 vs 4.98 days, p<0.001). All patients managed through the traditional pathway required ED assessment prior to admission. The ambulatory pathway was associated with reduced inpatient utilisation and improved access to timely symptom management. 

Conclusions and Relevance 

The ambulatory RACE paracentesis pathway enabled timely access to supportive care for patients with malignant ascites. The program successfully reduced burden on emergency department and inpatient resources were reduced without an increase in procedural complications Limitations include retrospective design, selection bias, and small sample size. These findings support ambulatory multidisciplinary pathways as feasible alternatives to traditional inpatient models and demonstrate the potential for advanced practice-led cancer services to improve both patient and health service outcomes.