SHM Converge Scientific Abstract ePoster Gallery-An Intervention to Improve the Multidisciplinary Care of Patients on the Cellular and Immunotherapy Service at the Cleveland Clinic

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This project evaluated and improved hospitalists’ readiness to care for patients on Cleveland Clinic’s Cellular and Immunotherapy Service (CITS), where admissions are rising due to CAR-T cells, bispecific antibodies, and other immune therapies. These treatments can cause serious toxicities such as cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), which require specialized inpatient management.<br /><br />The team surveyed hospitalists before the intervention and found that while many were familiar with management algorithms, communication about treatment plan changes was a major gap. Only about one-third felt adjustments were communicated effectively for commercial products, and even fewer for investigational therapies.<br /><br />To address this, the group created a 5-day orientation program from April to August 2025. The program included a didactic session on CAR-T, bispecific antibodies, CRS, and ICANS, followed by shadowing with the CITS rounding service alongside attending physicians, advanced practice providers, and hematology/oncology fellows. Seventeen hospitalists completed the pre-intervention survey, and nine completed the full orientation.<br /><br />After the orientation, hospitalists reported greater confidence in managing both CRS and ICANS. Agreement or strong agreement that they felt comfortable managing CRS increased from 58.9% to 77.8%, and confidence in managing ICANS rose from 52.9% to 77.8%.<br /><br />Qualitative feedback highlighted future improvement areas: better communication and handoff processes, clearer escalation thresholds, standardized care plans and order sets, nursing tools for early trigger recognition, and support for increasingly complex workloads.<br /><br />Overall, the intervention suggests that immersive orientation within a subspecialty team can improve hospitalist confidence and may enhance multidisciplinary care for patients receiving cellular and immunotherapy.

Asset Subtitle

Andrew Lyu

Meta Tag

Author List Andrew Lyu, John Molina, Juan Barbastefano, Sanjeev Suri, Tanveer Singh

Category Innovations

Concept Cellular Immunotherapy

Concept Cytokine Release Syndrome

Concept Immune Effector Cell-Associated Neurotoxicity Syndrome

Concept Multidisciplinary Care Team

Concept Bispecific Antibody

Distinguished Non-Finalist

Presenter Organization Cleveland Clinic

Presenting Author Andrew Lyu

Track Quality Improvement

Keywords

hospitalists

cellular immunotherapy service

CAR-T therapy

bispecific antibodies

cytokine release syndrome

ICANS

orientation program

multidisciplinary care

clinical confidence

inpatient management

Cellular Immunotherapy

Cytokine Release Syndrome

Immune Effector Cell-Associated Neurotoxicity Syndrome

Multidisciplinary Care Team

Bispecific Antibody