Adult Adult HemoglobinopathyHemoglobinopathy ProgramProgram

ObjectivesObjectives

•Information

•Facts

•Preparation

•Reassurance

• Dr. Molly Warner, Hemoglobinopathy Program Hematologist• Dr. Véronique Naessens, Hemoglobinopathy Program Hematologist• Alyson Turner, Associate Director of Nursing Medical Mission• Ellen Seguin, Nurse Coordinator Ambulatory Medical Mission• Lucia Francesangeli, Medical Day Hospital RN• Dale Macdonald, Transition Coordinator• Nadia Eldaoud, Pediatric Day Center Manager• Nathalie Aubin, Pediatric Day Center Assistant Manager• Annie Chaput, Complex Care Service RN

Working GroupWorking Group

Adult Adult HemoglobinopathyHemoglobinopathy ProgramProgram

• Team of hematologists• Dr. Molly Warner, Dr. Veronique Naessens and Dr. Patricia Pelletier

• New dedicated nurse case manager• for adult thalassemia and sickle cell population

• Availability Monday to Friday during daytime business hours

• Six nurses in day center to start and supervise transfusions

Making AppointmentsMaking Appointments

•Physician will decide when is the next transfusion and how many units of blood will be transfused•Appointments will be given by secretaries•Appointments will be given at the end of transfusion•Appointments could be given by phone•Appointments will always be given in advance•Last minute rescheduling; very difficult•Transfusions scheduled from Tuesday to Friday (Washed blood)•Date and time of appointments need to be respected•Treatment space allocated by st andardized length of treatment

No last minute reschedulingNo last minute rescheduling

Test CenterTest Center•Open Monday to Friday from 7h00 to 16h00•A requisition is needed for the Test Center•The cross match can be done up to 96 hours before the end of transfusion•Blood samples are drawn by a laboratory phlebotomist, not a nurse•If x-match done the same day, IV not started at the Test Center•Combining other specialty blood work, with requisition in hand

All blood work(CBC, XAll blood work(CBC, X--matchmatch……))

Medical Day HospitalMedical Day Hospital

•Arrival time to be respected•Registration with secretary•Waiting room•Called in to treatment space when:

Space availableNurse availableBlood available

•Single space treatment area•Wifi available

Transfusion dayTransfusion day

Medical Day HospitalMedical Day Hospital

•Nurses in Day Hospital to start and supervise transfusions•Day Hospital nurses will follow physician’s written orders•Thalassemia Program hematologists often present in the Day Hospital •Double identification; bracelet•Blood verified by 2 nurses•One unit of blood, at one time, will be sent to Day Hospital •No infusion pumps available until fall 2015

Clinical follow upClinical follow up

•Frequency of visits will be similar to what is done now•Clinic appointments will take place in the medical clinic cluster•When possible, appointments and transfusions will be coordinated with other visits

Major Benefit for Adult Thalassemia Patients•Imaging services and all sub-s pecialty services required to manage thalassemia patients are in the same building

Hematologist with nurse case managerHematologist with nurse case manager

Take Home PointsTake Home Points• Same highly qualified, specifically trained, specialised in hemoglobinopathy hematologists team on site

• Physician’s presence in the Day Hospital• Possiblility of acute, unplanned physical evaluation, if needed

• Same site availability of multiple types of investigations• Same site availability of adult services/sub-specialties• Possibility of coordinating multiple appointments• Single patient treatment space• Wifi available

Adult Adult HemoglobinopathyHemoglobinopathy ProgramProgram

Questions and comments please