Implementation of Post-Transplant Care Guidelines for Allogeneic Hematopoietic Stem Cell Transplant Recipients

Abstract

Purpose. The purpose of this quality improvement (QI) project was to implement an evidence-based follow-up guideline tool for allogeneic stem cell recipients who are over three months—or approximately 100 days—post-transplant at Banner MD Anderson Cancer Center (BMDACC). The goal was to encourage providers at BMDACC to utilize the guidelines to provide long-term follow-up care for allogeneic stem cell transplant patients after three months post-transplant.Background. Allogeneic (non-self-donor) hematopoietic stem cell transplant (HSCT) is a potentially curative procedure for several hematological malignancies. Allogeneic HSCT is associated with late complications—occurring after 100 days post-transplant—that impact survivors’ life expectancy and quality of life. Over 65,000 allogeneic HSCTs occur worldwide every year. Nearly 75% of survivors will experience at least one late complication. These complications physically, mentally, and emotionally affect survivors. Providing long-term follow-up care for these patients improves health and safety by preventing complications that put them at risk for early mortality. Methods. This QI project was implemented by providing education at a synchronous online meeting regarding allogeneic HSCT and late effects and introducing the guidelines. Two surveys were delivered via email to participants to complete before and after the education. A third survey was delivered via email three weeks after implementing the guidelines to evaluate provider use and impression. Results. Of the 12 individuals invited to participate, five participants responded to the pre-survey, one responded to the post-survey, and five responded to the follow-up survey. The one participant who completed the pre- and post-survey answered more questions correctly on the post-survey than the pre-survey. All but one provider answered that they used the guideline tool in practice and likely continue to use it. Conclusions. The one participant’s pre- and post-survey results showed that education was useful for learning about allogeneic HSCT and related complications. Multiple responses to the follow-up survey indicate that this is a promising project and is needed at the facility. With more planning and more time to implement, this could be a worthwhile project to re-do to improve allogeneic HSCT patients’ care