Improving and Streamlining Continuum of Care By Integrating Apheresis Collections within Our Clinical Program

Abstract

Apheresis collections is an integral part of any cellular therapy program. Continuum of care is critical to ensuring patient safety, improving staff and patient satisfaction, and reducing costs. As similar to other transplant centers, our apheresis collections were performed outside of the program. This department offered multiple services to the hospital system and lacked the appropriate infrastructure to provide pre and post supportive care thus requiring patients to receive care in various locations on the same day. Fragmented care impacts quality, costs, and outcomes. In an effort to address these issues, apheresis collections were merged to a newly created centralized ambulatory stem cell transplant unit. Apheresis collections were moved to a new physical location within the cancer center and we included pre and post collection assessments and supportive care. In addition to eliminating patient travel to multiple buildings in our large campus, it improved communication between nurses and physicians by integrating apheresis staff and activities within our program. It improved the effectiveness of mobilization to initiation of apheresis, allowing for collection during optimal elevation of stem cell counts. The unit was also designed to allow for multiple types of patient visits with easy access to the pharmacy located within our cancer hospital thus resulting in centralized management of care. To measure the impact of this process improvement initiative, we reviewed apheresis collection data with regard to number of collections per patient. The percentage of patients requiring multiple collections (i.e. 2 or more) was reduced from 64% to 45% decreasing cost by a minimum of $500 per case. Collection targets achieved increased from 79% to 89%. Incorporating apheresis collections into our cellular therapy program has improved and streamlined continuum of care for our patients. It has unified staff and activities thereby increasing operational effectiveness, improving patient satisfaction, and reducing costs.