Midori Nakagaki1, Nicole C Gavin2,3, Therese Hayes2, Rebecca Fichera4, Caroline Stewart2, Leonie Naumann5, Justine Brennan6, Natasha Perry2, Emma Foley7, Erin Crofton7, Christie Brown5, Jenni Leutenegger2, Glen A Kennedy2,8. 1. Pharmacy Department, Royal Brisbane and Women's Hospital, Brisbane, Australia. Midori.nakagaki@health.qld.gov.au. 2. Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, Australia. 3. School of Nursing, Queensland University of Technology, Brisbane, Australia. 4. Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Brisbane, Australia. 5. Physiotherapy, Royal Brisbane and Women's Hospital, Brisbane, Australia. 6. Social Work, Royal Brisbane and Women's Hospital, Brisbane, Australia. 7. Occupational Therapy, Royal Brisbane and Women's Hospital, Brisbane, Australia. 8. School of Medicine, The University of Queensland, Brisbane, Australia.
Abstract
PURPOSE: Patients who undergo haematopoietic stem cell transplantation (HSCT) often have multiple health issues following hospital discharge. In many centres, outpatient follow-up is solely conducted by specialist physicians. We aimed to implement and describe the outcomes of a nurse-allied health multidisciplinary clinic. METHODS: The clinic consisted of six disciplines-nursing, pharmacy, dietetics, physiotherapy, occupational therapy and social work. All allogeneic and high risk autologous HSCT patients were reviewed at 2 weeks after discharge and on day 100 post HSCT, with additional reviews as needed. Occasions of service, interventions, readmission data and physician satisfaction survey were collected prior to and after implementation. Additionally, patient feedback and quality of life survey (FACT-BMT) were collected during the first 6 months. RESULTS: From July to December 2019, 57 patients were reviewed in the clinic (475 reviews, average 8.3 reviews per patient). Common interventions included the following: exercise programs by physiotherapist (n = 111), diet prescription (n = 103), counselling by social worker (n = 53), medication lists provision (n = 51), fatigue management (n = 43) and nurse education (n = 22). The clinic did not reduce patients' readmission rate; however, positive feedback from patients and physicians were reported. FACT-BMT results demonstrated that there are unmet needs, particularly fatigue management, sexual education and support, body images, back to work support and quality of life improvement. From discharge to day 100, there was no significant improvement in quality of life. CONCLUSIONS: This clinic provides an innovative approach to patient-centred care in HSCT. It has been well received by patients who were supported by multidisciplinary interventions.
PURPOSE: Patients who undergo haematopoietic stem cell transplantation (HSCT) often have multiple health issues following hospital discharge. In many centres, outpatient follow-up is solely conducted by specialist physicians. We aimed to implement and describe the outcomes of a nurse-allied health multidisciplinary clinic. METHODS: The clinic consisted of six disciplines-nursing, pharmacy, dietetics, physiotherapy, occupational therapy and social work. All allogeneic and high risk autologous HSCT patients were reviewed at 2 weeks after discharge and on day 100 post HSCT, with additional reviews as needed. Occasions of service, interventions, readmission data and physician satisfaction survey were collected prior to and after implementation. Additionally, patient feedback and quality of life survey (FACT-BMT) were collected during the first 6 months. RESULTS: From July to December 2019, 57 patients were reviewed in the clinic (475 reviews, average 8.3 reviews per patient). Common interventions included the following: exercise programs by physiotherapist (n = 111), diet prescription (n = 103), counselling by social worker (n = 53), medication lists provision (n = 51), fatigue management (n = 43) and nurse education (n = 22). The clinic did not reduce patients' readmission rate; however, positive feedback from patients and physicians were reported. FACT-BMT results demonstrated that there are unmet needs, particularly fatigue management, sexual education and support, body images, back to work support and quality of life improvement. From discharge to day 100, there was no significant improvement in quality of life. CONCLUSIONS: This clinic provides an innovative approach to patient-centred care in HSCT. It has been well received by patients who were supported by multidisciplinary interventions.
Authors: R P McQuellon; G B Russell; D F Cella; B L Craven; M Brady; A Bonomi; D D Hurd Journal: Bone Marrow Transplant Date: 1997-02 Impact factor: 5.483
Authors: Paul A Harris; Robert Taylor; Brenda L Minor; Veida Elliott; Michelle Fernandez; Lindsay O'Neal; Laura McLeod; Giovanni Delacqua; Francesco Delacqua; Jacqueline Kirby; Stephany N Duda Journal: J Biomed Inform Date: 2019-05-09 Impact factor: 6.317
Authors: Dina Watterson; Kerrie Walter; Lisa O'Brien; Desiree Terrill; Kathleen Philip; Indi Swan; Lisa Somerville Journal: Int J Qual Health Care Date: 2019-03-01 Impact factor: 2.038