Transplant Energize Me Patient Outcome (TEMPO): A Quality Improvement Project that Maintains Functional Mobility in...

Area of Science:

• Pediatric Hematology
• Transplantation Medicine
• Rehabilitation Science

Background:

• Allogeneic hematopoietic cell transplantation (HCT) is a curative treatment for pediatric hematologic diseases.
• HCT leads to significant physical deconditioning, impacting daily function and increasing health risks.
• Maintaining physical function during HCT is crucial for patient recovery and long-term outcomes.

Purpose of the Study:

• To implement and evaluate the Transplant Energize Me Patient Outcome (TEMPO) project, a quality improvement initiative.
• To maintain physical functional mobility and strength in pediatric allogeneic HCT patients throughout hospitalization.
• To assess the impact of TEMPO on resource utilization and compare it with historical controls.

Main Methods:

• The TEMPO project incorporated individualized, developmentally appropriate exercises managed by a multidisciplinary team.
• Objective physical stamina metrics were recorded at admission, weekly, at discharge, and 100 days post-graft infusion (D100).
• Resource utilization (length of stay, parenteral feeds, narcotics, readmissions, infections) was compared between TEMPO and pre-TEMPO cohorts.

Main Results:

• TEMPO participation preserved physical endurance and functional strength during hospitalization.
• These improvements in physical function were significantly sustained or enhanced at D100.
• No significant differences in resource utilization were observed between the TEMPO and historical control groups.

Conclusions:

• The TEMPO quality improvement project effectively maintains physical functional mobility, strength, and endurance in pediatric allogeneic HCT patients.
• The observed benefits in physical function are objectively sustained at 100 days post-transplant.
• TEMPO demonstrates a successful strategy to mitigate deconditioning associated with HCT in pediatric populations.