Making a Difference: A QI Approach to Improving Electrolyte Replacement Practice on an Inpatient Malignant Hematology and Cellular Therapy Unit

Abstract

Addressing these challenges with HIT has the potential to increase care delivery and coordination, and ensure positive outcomes. The purpose of this study was to examine the use of a user-centered HIT app "BMT Roadmap" in a sample of adult and pediatric HCT patient-caregiver dyads. Methods: We used a mixed methods approach to collect quantitative and qualitative person-reported outcome measures (PROs) longitudinally upon admission, discharge, and day 100 post-HCT. Adult and pediatric patient caregivers (n = 39) completed encrypted psychometric surveys and inperson semi-structured interviews. Qualitative data were derived from multiple-reviewer thematic analysis. Results: Adult caregivers logged on fewer days than pediatric caregivers (M = 10.09 + 10.67 versus M = 18.26 + 14.35 respectively; t = -1.82, p = .07), reflecting differences in lengths of stay and thus access to the app. After statistical correction for differing access, we found caregivers used the app mostly for viewing patient laboratory values, and adult caregivers devoted more time to the medication and phases of care modules (t = 2.52, p = .02; t = 1.87, p = .07 respectively). Most adult and pediatric caregivers identified separate educational, organizational, and psychosocial needs during the phase of the transplant. However, both found BMT Roadmap informative and valuable for the caregiving experience. Conclusion: Caregivers of adult and pediatric patients receiving first-time allogeneic HCT report different caregiving experiences. Thus, they desire different interventions to learn best practices of caregiving. Clearly delineating differences in caregiving for adult and pediatric patients helps with customizable HIT design and may improve long-term patient outcomes.