Abstract
A performance improvement initiative was undertaken to establish treatment guidelines for the management of infusion-related hypersensitivity reactions (iHSRs) secondary to the administration of chemotherapy/biologic therapy and to develop an efficient process to ensure application of these standards in the care of patients at increased risk of experiencing iHSRs. The project yielded a standardized approach that ensures the application of an evidence-based standard of care in managing these reactions. In addition, the effort resulted in improvements in the reporting of this type of adverse drug reaction (ADR) to the institutional ADR reporting program.
The Published report from the Institute of Medicine (IOM), Ensuring Quality Cancer Care,1 identifies steps that can be taken to improve the delivery of cancer care. The report indicates that cancer care is optimally delivered at centers that ensure the use of several recommended practices. One recommendation is to "use systematically developed guidelines based on the best available evidence for prevention, diagnosis, treatment, and palliative care."1(p.4) The following initiative is but one effort to improve the quality of care to oncology patients receiving chemotherapy/biologic therapy at Memorial Sloan-Kettering Cancer Center (MSKCC). This improvement in quality of care was accomplished through the development and application of evidence-based guidelines directed at the management and treatment of chemotherapy/biologic therapy infusion-related hypersensitivity reactions (iHSRs). This iHSR initiative is one segment of a larger performance improvement initiative undertaken to standardize many aspects of patient care related to chemotherapy/biologic therapy delivery.
The primary objective of the iHSR initiative was the development of evidence-based guidelines for the management of iHSRs secondary to the administration of chemotherapy/biologic therapy. The goal was to ensure application of these treatment standards into the care of patients identified at increased risk of experiencing an iHSR. Implementing this clinical process also augmented the institutional adverse drug reaction (ADR) reporting program by improving the capture and reporting of this type of ADR.