Over the last year, the Medical City Dallas Blood and Marrow Transplant (BMT) Program quality management team implemented a formal process to solicit feedback from the processing facility, collection facility, and the clinical programs within the BMT Program. The information received is used to improve interactions and processes, as well as meeting and/or exceeding Foundation for the Accreditation of Cellular Therapy (FACT) requirements. <b>Background:</b> Feedback is one of the most powerful influences for learning and achieving process improvements, but its impact can be positive, negative, or neutral. The 7<sup>th</sup> edition <i>FACT-JACIE International Standards</i> requires that the Quality Management Plan include, or summarize and reference, policies and procedures for obtaining feedback from associated Clinical, Collection and Processing Facilities. Figure 1, "Feedback Flow between Program Facilities", illustrates the flow of feedback between facilities. <b>Method:</b> To facilitate the collection of data, an electronic survey instrument was used to expedite survey completion. Over a 10-month period, the Quality Manager, assisted by the program's BMT Secretary, sent out bi-weekly feedback surveys and to each facility. If facility staff did not return surveys, reminders were sent again after 3 days and then again after 10 business days (refer to figure 2. "Survey Questions and # of Returns"). Returned surveys are then analyzed. Results and any concerns are presented during the program's quarterly quality meetings for review and endorsement of performance improvement plans. <b>Analysis:</b> To date, the responses have been approximately 90% positive; the other 10% suggested that professional communication could be improved (refer to Figure 3. "Example Feedback"). Some survey respondents remarked that fear of retaliation arising from negative comments prevented them from responding honestly and openly. <b>Results:</b> The survey process has been well received, providing actionable feedback. The evidence confirms that the type of feedback, and the way it is delivered, can be perceived as positive or negative. As one outcome of the survey process, documents are now placed on a shared drive folder so that staff who need them can access them directly. This has improved information flow and communication within the team. The Program is investigating opportunities to improve interpersonal communication approaches in order to improve "sense of team". From the perspective of this program, in addition to surpassing FACT requirements, this initiative provides ways in which feedback can be used to improve communications and streamline processes between facilities.
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