scholarly journals National Survey of Hematopoietic Cell Transplantation Center Personnel, Infrastructure, and Models of Care Delivery

2015 ◽  
Vol 21 (7) ◽  
pp. 1308-1314 ◽  
Author(s):  
Navneet S. Majhail ◽  
Lih-Wen Mau ◽  
Pintip Chitphakdithai ◽  
Tammy Payton ◽  
Michael Eckrich ◽  
...  
Keyword(s):  
Cell Transplantation ◽  
National Survey ◽  
Hematopoietic Cell Transplantation ◽  
Care Delivery ◽  
Models Of Care ◽  
Hematopoietic Cell ◽  
Transplantation Center

scholarly journals Patient-centered care coordination in hematopoietic cell transplantation

2017 ◽  
Vol 1 (19) ◽  
pp. 1617-1627 ◽  
Author(s):  
Nandita Khera ◽  
Patricia Martin ◽  
Kristen Edsall ◽  
Anthony Bonagura ◽  
Linda J. Burns ◽  
...  
Keyword(s):  
Cell Transplantation ◽  
Care Coordination ◽  
Hematopoietic Cell Transplantation ◽  
Care Delivery ◽  
Treatment Options ◽  
Hematopoietic Cell ◽  
Coordinated Care ◽  
Patient Centered ◽  
Simplified Approach ◽  
Coordination Model

Abstract Hematopoietic cell transplantation (HCT) is an expensive, resource-intensive, and medically complicated modality for treatment of many hematologic disorders. A well-defined care coordination model through the continuum can help improve health care delivery for this high-cost, high-risk medical technology. In addition to the patients and their families, key stakeholders include not only the transplantation physicians and care teams (including subspecialists), but also hematologists/oncologists in private and academic-affiliated practices. Initial diagnosis and care, education regarding treatment options including HCT, timely referral to the transplantation center, and management of relapse and late medical or psychosocial complications after HCT are areas where the referring hematologists/oncologists play a significant role. Payers and advocacy and community organizations are additional stakeholders in this complex care continuum. In this article, we describe a care coordination framework for patients treated with HCT within the context of coordination issues in care delivery and stakeholders involved. We outline the challenges in implementing such a model and describe a simplified approach at the level of the individual practice or center. This article also highlights ongoing efforts from physicians, medical directors, payer representatives, and patient advocates to help raise awareness of and develop access to adequate tools and resources for the oncology community to deliver well-coordinated care to patients treated with HCT. Lastly, we set the stage for policy changes around appropriate reimbursement to cover all aspects of care coordination and generate successful buy-in from all stakeholders.

Team Cognition As a Means to Improve Care Delivery in Critically Ill Patients With Cancer After Hematopoietic Cell Transplantation

2016 ◽  
Vol 12 (11) ◽  
pp. 1091-1099 ◽  
Author(s):  
Nathan J. McNeese ◽  
Nandita Khera ◽  
Sara E. Wordingham ◽  
Noel Arring ◽  
Sharon Nyquist ◽  
...  
Keyword(s):  
Cell Transplantation ◽  
Cognitive Processing ◽  
Hematopoietic Cell Transplantation ◽  
Care Delivery ◽  
Clinical Care ◽  
Multidisciplinary Care ◽  
Hematologic Malignancies ◽  
Poor Quality ◽  
Hematopoietic Cell ◽  
Team Cognition

Hematopoietic cell transplantation (HCT) is an important and complex treatment modality for a variety of hematologic malignancies and some solid tumors. Although outcomes of patients who have undergone HCT and require care in intensive care units (ICUs) have improved over time, mortality rates remain high and there are significant associated costs. Lack of a team-based approach to care, especially during critical illness, is detrimental to patient autonomy and satisfaction, and to team morale, ultimately leading to poor quality of care. In this manuscript, we describe the case of a patient who had undergone HCT and was in the ICU setting, where inconsistent team interaction among the various stakeholders delivering care resulted in a lack of shared goals and poor outcomes. Team cognition is cognitive processing at the team level through interactions among team members and is reflected in dynamic communication and coordination behaviors. Although the patient received multidisciplinary care as needed in a medically complicated case, a lack of team cognition and, particularly, inconsistent communication among the dynamic teams caring for the patient, led to mixed messages being delivered with high-cost implications for the health-care system and the family. This article highlights concepts and recommendations that begin a necessary in-depth assessment of implications for clinical care and initiate a research agenda that examines the effects of team cognition on HCT teams, and, more generally, critical care of the patient with cancer.

scholarly journals Psychosocial and financial issues after hematopoietic cell transplantation

Hematology ◽  
2021 ◽  
Vol 2021 (1) ◽  
pp. 570-577
Author(s):  
David Buchbinder ◽  
Nandita Khera
Keyword(s):  
Cell Transplantation ◽  
Hematopoietic Cell Transplantation ◽  
Psychosocial Care ◽  
Models Of Care ◽  
Hematopoietic Cell ◽  
Patient Centered ◽  
Center Staff ◽  
The Status ◽  
Centered Care ◽  
Improvement In Survival

Abstract With improvement in survival after hematopoietic cell transplantation (HCT), it has become important to focus on survivors' psychosocial issues in order to provide patient-centered care across the transplant continuum. The goals of this article are to describe updates in the literature on certain psychosocial domains (emotional/mental health and social/financial) in HCT survivors, offer a brief overview of the status of the screening and management of these complications, and identify opportunities for future practice and research. An evidence-based approach to psychosocial care can be broken down as primary (promoting health, raising awareness, and addressing risk factors), secondary (screening and directing early pharmacological and nonpharmacological interventions), and tertiary (rehabilitating, limiting disability, and improving quality of life) prevention. Implementing such an approach requires close coordination between multiple stakeholders, including transplant center staff, referring hematologist/oncologists, and other subspecialists in areas such as palliative medicine or psychiatry. Innovative models of care that leverage technology can bring these stakeholders together to fulfill unmet needs in this area by addressing barriers in the delivery of psychosocial care.

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