(80) Implementation of Blinatumomab Home Infusion Workflow Process in Pediatric Patients: A Collaboration Between a Children’s Hospital and Home Healthcare Companies

Title: Implementation of Blinatumomab Home Infusion Workflow Process in Pediatric Patients: A Collaboration Between a Children’s Hospital and Home Healthcare Companies

Abstract : Basis of Inquiry: Blinatumomab, a 28-day continuous infusion, has become the standard of care for pediatric patients with standard-risk B-cell acute lymphoblastic leukemia yet, there is no established protocol to implement this in the real-world setting.

Purpose/

Objectives: To develop a blinatumomab home infusion workflow process in partnership with two home healthcare companies and the Children’s Hospital of Richmond to ensure safe transition of care.

Methods: A multidisciplinary team made up of a nurse navigator, pharmacist, and healthcare professionals from two home healthcare companies collaborated to establish a standardized workflow process for blinatumomab home infusion. The team conducted a gap analysis to identify key safety, logistical, and communication challenges associated with transitioning patients on continuous blinatumomab infusion initiated in the hospital to home care. A comprehensive workflow process outlining roles and responsibilities was developed, including care coordination, medication bag changes, delivery logistics, and troubleshooting the infusion pump. Standardized patient and caregiver education materials were developed to promote understanding of home infusion procedures, location of bag changes, and appropriate healthcare contacts. The workflow process underwent PDSA cycles. Measurements included qualitative data collected from the home healthcare companies, patient families and caregivers.

Findings/Outcomes: There were 18 blinatumomab cycles in 9 pediatric patients analyzed, with 9 cycles pre-implementation and 9 cycles post-implementation. Implementation of a standardized workflow process streamlined coordination between the hospital and home healthcare companies by enhancing communication pathways and role delineation across the teams. Home healthcare providers reported improved ability to preform tasked aligned with clinical practices, contributing with consistency of care and strengthening patient provider relationships. Caregivers reported improved confidence and satisfaction with home infusion. This initiative demonstrates that home infusion of blinatumomab in collaboration with a home healthcare company is a feasible and safe alternative to prolonged hospitalization when a structured workflow process is in place.