Formation of a Dedicated Graft Versus Host Disease Committee to Improve Outcomes in Allogeneic Hematopoietic Cell Transplant Patients

Abstract

Graft Versus Host Disease (GVHD) is common, complex and at times difficult to differentiate from other complications. GVHD is the leading cause of non-relapse mortality after hematopoietic cell transplant (HCT). Current treatments for GVHD are only partially effective and response rates for first-line treatment of acute GVHD are A 12-person multidisciplinary GVHD committee was formed consisting of advanced practice providers, oncologists, and data and quality specialists. This committee meets monthly to systematically review all current cases of acute and chronic GVHD. Documentation review consists of date of incidence, maximum grade, treatment initiation, discontinuation and response to each line of treatment for weekly acute GVHD assessment and the completion of assessment at 100 days, 6 months, and 1 year for chronic GVHD. Documentation feedback and/or request for clarification is entered into the electronic medical record in the form of a documentation clarification entry. Additional efforts to promote a team based approach include GVHD educational opportunities to enhance assessment skills and discussion of treatment options, including GVHD clinical trials. Documentation review triggers an email recommendation to the provider to consider referral to our chronic GVHD multidisciplinary clinic and the resources of a GVHD specialist. Metrics used to evaluate this project include incidence and grade of acute GVHD, frequency of clarification requests, accuracy of provider documentation, and number of referrals to chronic GVHD clinic. Preliminary results at 6 months for 19 acute GVHD and 44 chronic GVHD cases reviewed indicate improved accuracy in documentation.