Subscriber Benefit
As a subscriber you can listen to articles at work, in the car, or while you work out. Subscribe Now
Transplant Optimization Program, Franciscan Health
People with bone-related cancers go through a lot of medically needed treatments that debilitate the body. Franciscan Health’s Transplant Optimization Program was created to help strengthen patients before and after treatment, improving the outcomes of their procedures and reducing both caregiver burden and the need for rehospitalization.
Sandra Scherschel, Franciscan’s manager of specialty therapy services, described TOP as “a way to prepare the body for transplant and then assist the body to get back to where it was physically after [patients] undergo cancer treatment and transplant.”
“Before they get their transplant, if they are identified as someone who may be a little bit on the weaker side to begin with, we want to build them up so that they can undergo treatment successfully and not have a bunch of other things come up medically,” she said. “And then after their transplant, we want to build them back up to what they were doing before this cancer episode ever happened.”
TOP came together about 2-1/2 years ago when clinical physical therapist Macy Hogan joined Franciscan Health from Indiana University Health, which had a similar program for heart and lung transplant patients. She and oncologist Dr. Felix Mensah, working with Indiana Blood & Marrow Transplantation—a Franciscan Health program that provides inpatient and outpatient care for hematological disorders and blood cancers—established the TOP program for blood- and marrow-transplant patients.
“We started knowing that this was a big gap in care in general in Indiana for patients going through a transplant process with blood- or marrow-related disease,” Hogan said.
The process for transplant patients typically starts with a consultation with a transplant doctor to determine if they’re an appropriate candidate medically and what treatment might be best for them. At that point, they are referred to TOP, where a physical therapist tests a patient’s fitness and determines if the patient is at risk. When a need is identified through testing, the program provides continued therapy, whether it’s before, during or after the patient’s course of treatment.
Putting at-risk patients through transplant surgery “is not ideal because we’re already taking someone who’s down and out, and we’re going to push them down even further,” Hogan said. “So we screen for frailty from the beginning, and then we give them education about what to expect” from their surgery.
Franciscan Health reports that TOP has:
ω Improved patient outcomes related to bone-marrow transplants, including decreasing average length of hospital stay, reducing adverse events, reducing readmission rates and improving overall quality of life after transplant.
ω Improved the candidacy of patients who need a transplant but had a poor performance status and would have otherwise not received a transplant.
ω Made outpatient transplants more feasible, which provides cost savings to the patient and health care system.
“What we know about TOP is that it’s proven to have better outcomes,” Scherschel said. “It gets more people to transplant who might have been told that they’re not a good candidate. We’re able to get more people the treatment that they need, and we’re able to get people back to their normal life sooner. It’s been a huge benefit to the patients that unfortunately have to go through this process.”•
Please enable JavaScript to view this content.