Nurse Manager UCLA Health Los Angeles, California, United States
Title: Pediatric Infusion – Outpatient Chemotherapy Transition The transition from inpatient to outpatient infusion settings for pediatric hematology/oncology patients presents an opportunity to reduce treatment costs while enhancing patient experiences. Current literature supports the effectiveness of outpatient care in maintaining patient normalcy, reducing clinical stress, and optimizing healthcare resources. However, the need for clear criteria, protocols, and patient education in outpatient settings remains an area for improvement, particularly in ensuring that these transitions do not compromise treatment outcomes.
This QI project aims to evaluate the feasibility and effectiveness of transitioning selected pediatric hematology/oncology patients receiving VDC/E&I therapy to outpatient infusion settings. The objective is to determine whether this transition can maintain treatment efficacy while improving patient satisfaction, reducing hospital resource utilization, and ensuring patient safety This project implemented an outpatient infusion protocol for pediatric patients eligible for VDC/E&I therapy. The intervention included the creation of eligibility criteria, a timeline and algorithm for treatment planning, and guidelines for discharge medications such as chemotherapy adjuvants (Mesna, Neulasta & hydration). Clinical outcomes were tracked to evaluate the effectiveness of the outpatient infusions, with particular attention to whether patients required additional inpatient monitoring or treatment.
Results indicated that patients who met the established outpatient eligibility criteria and received VDC/E&I therapy in the outpatient setting tolerated their treatments well. From the 10 potential inpatient admissions, all infusions were successfully administered in the infusion center without the need for additional inpatient monitoring or treatment. Patient feedback was positive, highlighting improved comfort and reduced stress. These findings suggest that transitioning eligible patients to outpatient infusions can be a successful model for optimizing both patient care and hospital resource utilization in pediatric hematology/oncology nursing.
This QI initiative demonstrates that a structured approach to outpatient infusions can maintain efficacy while improving the patient experience, offering valuable insights for further optimization of outpatient care.
