Early Identification of HCT Patient Discharge Needs

Background: Patients who receive stem cell transplants in order to treat life threatening diseases deal with a variety of stressors throughout their treatment course. These stressors can cause additional mental anguish as patients receive their treatment and transplant. Early identification of these stressors may enable interventions in order to decrease and relieve stress caused by a variety of home and life issues.

Purpose: On a 36 bed HCT unit it was determined there were a variety of issues that resulted in additional stress during the inpatient stay. These issues were determined to be one of the causes of delayed discharge from the hospital following transplant. An intervention was developed to identify issues that resulted in additional stress upon the patient's admission to the hospital for stem cell transplant.

Intervention: A survey was developed in order to obtain information from the patient regarding issues that may cause distress during their hospitalization and potentially delay their discharge. This survey is administered via tablet device to each patient admitted for stem cell transplant on the day following admission. The questions inquire if there are any concerns the patient has in the following areas: financial, home life, communication with the healthcare team, physical restrictions, anxiety, fatigue and psychosocial concerns. When the patient identifies a need/concern in any of the areas, a consult is automatically generated and sent to the appropriate discipline. This consult alerts the discipline that the patient is inpatient and in need of assistance. The consulting service is able to assess the needs of the patient and intervene early on in the patient's admission in order to formulate an action plan.

Evaluation: Upon completion of the pilot on this unit, the collected data will be evaluated for the effectiveness of early identification of HCT patient needs and the impact on discharge. This will assist the healthcare team in identifying patient needs and addressing them throughout the patient's hospitalization.

Discussion: Undergoing stem cell transplant is a stressful experience for both the patient and their families. With early identification of needs, support can be provided to decrease added stress through this life saving treatment.