JACIE accreditation for blood and marrow transplantation: past, present and future directions of an international model for healthcare quality improvement

Abstract

Blood and marrow transplantation (BMT) is a complex and evolving medical speciality that makes substantial demands on healthcare resources. To meet a professional responsibility to both patients and public health services, the European Society for Blood and Marrow Transplantation (EBMT) initiated and developed the Joint Accreditation Committee of the International Society for Cellular Therapy and EBMT—better known by the acronym, JACIE. Since its inception, JACIE has performed over 530 voluntary accreditation inspections (62% first time; 38% reaccreditation) in 25 countries, representing 40% of transplant centres in Europe. As well as widespread professional acceptance, JACIE has become incorporated into the regulatory framework for delivery of BMT and other haematopoietic cellular therapies in several countries. In recent years, JACIE has been validated using the EBMT registry as an effective means of quality improvement with a substantial positive impact on survival outcomes. Future directions include development of Europe-wide risk-adjusted outcome benchmarking through the EBMT registry and further extension beyond Europe, including goals to faciliate access for BMT programmes in in low- and middle-income economies (LMIEs) via a ‘first-step’ process.

Providing both autologous and allogeneic hematopoietic stem cell transplants (HSCT) may have a stronger impact on the outcome of autologous HSCT in adult patients than activity levels or implementation of JACIE at Belgian transplant centres

“…Patients younger than 16 years (n = 121) and transplants for solid tumours were excluded (n = 77). Centres that performed less than 5 auto-HSCT per year on average were excluded (n = 79 transplants from 3 centres), according to the FACT-JACIE standards [15]. Finally, 5 records had a missing vital status, resulting in a total of 2697 auto-HSCT records for outcome analyses from 17 Belgian centres.…”

“…Quality management organizations were launched end of the 1990's, FACT (Foundation for the Accreditation of Cell Therapy) in the USA followed by JACIE (Joint Accreditation Committee-ISCT [International Society for Cellular Therapy] & the EBMT [European Society for Blood and Marrow Transplantation]) in Europe (https://www.ebmt. org/jacie-accreditation) to improve the quality of HSCT [15]. While increasing evidence suggests that patient outcome has been improved for allo-HSCT since the introduction of the JACIE quality management system (QMS) [16][17][18], results remain contradictory for auto-HSCT in Europe.…”

The EBMT activity survey on hematopoietic-cell transplantation and cellular therapy 2018: CAR-T’s come into focus

“…The survey using a standardized structure captures the numbers of HCT from highly committed participating teams, divided by indication, donor type, and stem cell source. In the last years with the dramatic increase of cellular therapies, the survey also includes information on cellular therapies with hematopoietic cells for uses other than to replace the hematopoietic system [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]. The analysis of the survey data since 1990 shows a continued and constant increase in the annual numbers of HCT and transplant rates for both allogeneic and autologous HCT.…”

Evolution, trends, outcomes, and economics of hematopoietic stem cell transplantation in severe autoimmune diseases

“…In addition, the EBMT and JACIE are currently developing a benchmarking system for center transplant outcomes across all indications. 36 In conclusion, HSCT for AD has evolved gradually on the back of preclinical experiments, circumstantial data, sporadic treatments, and small-scale clinical trials to more robust evidence from large database studies and high-quality randomized controlled trials and other trial data. "Implementation science" is now needed to bring the field properly into routine clinical practice alongside alternative treatments and in tandem with clinical science, health economics, and education.…”

“…The impact of accreditation by the Joint Accreditation Committee of the International Society for Cellular Therapy and EBMT (JACIE), which awarded its first accreditation in 2001, 36 was investigated according to transplants being performed in centers before or without JACIE accreditation vs after JACIE accreditation, based on the date of JACIE accreditation being awarded (data source: JACIE Office, Barcelona, Spain).…”