Congress Abstracts 2004

56

A COLLABORATIVE PRACTICE MODEL FOR HEMATOLOGY/ONCOLOGY AND TRANSPLANT CARE. Georgie Cusack, RN, MS, Margaret Bevans, RN, MS, AOCN^®, Helen Mayberry, RN, MS, and Kim Scott, RN, BSN, OCN^®, National Institutes of Health, Bethesda, MD.

The Clinical Center (CC) of the National Institutes of Health (NIH) is a hospital solely dedicated to conducting biomedical research. In preparing for the opening of a new clinical research center (CRC) and the merging of currently separate units, it was identified that practice standards varied among hematology/oncology and transplant (HOT) programs. Merging practices can be a challenging task, but the literature documents positive outcomes for patients and staff with standardized approaches to care.

This abstract describes the process utilized by the HOT team to develop a new paradigm of practice. The goal is to optimize patient and family care during participation in biomedical research by standardizing clinical care not directed by research objectives.

The process started with the identification of stakeholders to serve on the task force. Individuals from various disciplines with HOT expertise, representing in-patient and outpatient areas, were recruited. This included physicians, nurses, clinical nurse specialists, nurse managers, nutritionists, pharmacists, social workers, and specialty consultants from various disciplines. The next steps were 1) identification of similarities and differences in clinical practice; 2) topic prioritization; 3) delegation of shared responsibilities; and 4) timeline development. Subgroups were organized based on five topic areas that were consented upon to guide the work. These were 1) unit infrastructure (clinical practice and administrative), 2) infectious disease guidelines, 3) psychosocial support and resource management, 4) complication management, and 5) consultative services. Each group considered current practice, evidence-based practice, pre-existing guidelines, and community standards as the foundation for their work.

Program improvements as a result of the HOT team include the standardization of protocol management, infectious disease guidelines, formal mechanisms of communication, consolidation of resources, and improved patient and family supports (social, financial, and psychological).

This collaborative practice model was not without obstacles, but with the dedication by the stakeholders and the assessment of clinical applicability prior to implementation, the adoption of this work has improved clinical, research, and staff outcomes.