The Levine Cancer Institute Blood & Marrow Transplant Program Charlotte, NC

1. The Levine Cancer InstituteBlood & Marrow Transplant ProgramCharlotte, NC Lynn Sanders MSN, RN, OCN Administrative Director Adult Blood & Marrow Transplant Program Department of Hematologic Oncology & Blood Disorders

2. Where is charlotte, NC? There are 919.99 miles from Charlotte to Omaha in northwest direction and 1,147.99 miles (1,847.51 kilometers) by car, following the I-70 route. Charlotte and Omaha are 16 hours 3 mins far apart, if you drive non-stop. This is the fastest route from Charlotte, NC to Omaha, NE. The halfway point is Goreville, IL. *Please note that the time difference between Charlotte, NC and Omaha, NE is 1 hour.

3. The journeyPhase I 1st Kick-off: January 29th & 30th 2016 Goal System Overview Deep Dive into workflow solutions Project Components Breakout sessions-Subject Matter Experts

4. The journey Phase II 2nd Kick-off: March 23rd & 26th 2016 Goal System Overview Referral Management Financial Management Pre-TX Recipient and Donor Evaluations Cell Collection Workflow Admission and Discharge Post Transplant Management CIBMTR Data Management

5. Pause…

6. The Plan Plan Allowed each area to develop a backloading system Shared responsibility: “Our Program” Identified an OTTR “Champion” in each area Goals Required deadlines to accompany each plan Managers responsible for ongoing review & support Tracking Progress Weekly meeting with Admin & Data IS to monitor progress Reviewed issues or concerns & attempted resolution Communicated back to the team during monthly team meetings via the OTTR “Champion” Monitoring of input with internal audits

7. Major Backload approach Research/Data Coordinators (RDC) Plan Organized all transplant patients in Alphabetical order Grouped by transplant type Split each list (auto & allo) into thirds Phase I June 1st-45patients (15pts/RDC to backload) Phase II March 2014-May 31, 2016- 182 pts total (60 pts/data RDC to backload)

8. Major Backload approach Cont’d Time Commitment 2 days/ week off-site 1st group-Autos-started (Nov 2016-April 2017) 2nd group-Autos (April 2017-May2017) 3rd group-Expired patients Goal All backloading to be completed 2 wks before CPI was due

9. The hiccups Time Major backload (2014-Nov) completed Continue to transplant patients Minor backload 60 patients to be completed Split between two RDC Goal 9/15/2017

10. Backload approach Transplant Coordinators(TC) Plan Time frame of backload: 2/21-3/13 All patient names were placed in a fishbowl (30patients) TC drew a name during downtime & completed backload TC became responsible for their own patient Time Commitment Goal Complete back load after Research/data Coordinators June 1st backload to keep patients current.

11. Backload approach Apheresis Unit Plan Form was created that allowed collection of pertinent info from EMR 56 patients required data to be backloaded Time commitment 10min per pt to find info and complete the form 5-10 min to transfer info from the form into OTTR Goal Complete all backloading of collections from 11/1/16-4/5/17

12. APHERESIS OTTR CHECKLIST

13. Backload approach Stem Cell Processing Lab Plan All teammates worked on data entry Time commitment Auto collection 9-10min per DIN number Allo collection 4-5min Auto Infusion record entry 5-6min for 6 bags Allo infusion record entry less than 3min Goal Enter data on patients with Active Mob/Collection encounters Complete back load by mid-March 2017

14. Results Increased input Increased teammate engagement Increased leadership engagement

15. WHERE ARE WE TODAY?

16. QUESTIONS?