Session: 901. Health Services and Quality Improvement - Non-Malignant Conditions: Poster III
Hematology Disease Topics & Pathways:
Research, Sickle Cell Disease, Clinical Practice (Health Services and Quality), Clinical Research, health outcomes research, Diversity, Equity, and Inclusion (DEI) , Hemoglobinopathies, patient-reported outcomes, Diseases, young adult , Study Population, Human
ST3P-UP study demographics: N=291, mean age 18.8y (SD1.5); 52% F; 96% Black; 3.6 acute care visits/yr. at baseline (range 0-31, SD4.9). Over 84% of participants reported being usually or always satisfied with the QOC when care was needed right away. Overall health care was rated between 7-10 (10 = best care possible) by 83%; 73% reported they usually or always were able to access care right away when needed while 78% usually or always waited <2h to receive treatment for their acute pain. These reports were equivalent to that reported when SCD experts care for SCD patients.
QOC scores for ED care were higher than previously published and also better than anecdotal reports. Specifically, patients reported that they felt the doctors (84% of the time) and nurses (83% of the time) usually or always seemed to really care about them and that when they needed care right away, they were treated with courtesy and respect by clerks and receptionists usually or always 87% of the time. Only 11% of participants reported that providers were able to only help their pain “a little or not at all” and that providers “did not” or “only slightly” believed their report of pain, respectively. Participants were usually or always satisfied with the care received in the ED 94.1% of the time. However, a bad experience continues to drive the decision to avoid going to the ED for care in 63% of participants. A previous report by Kanter et al cited only 51% of adults with SCD were usually or always satisfied with the ED care received and 52% indicated a bad experience in the ED led them to decide to avoid seeking care.6
These results demonstrate a surprisingly higher satisfaction with the quality, process and outcomes of ED care delivered and less discrepancy between ambulatory vs. ED care than expected compared to published and anecdotal reports. This could reflect the bias of ST3P-UP study enrollment and a younger patient population with ~25% having <1 baseline acute visits /yr. ST3P-UP sites had existing strong partnerships with providers, a local CBO and established CABs thus care may not be generalizable to the broader SCD care ecosystem. While longitudinal survey results will be important as comparison, our data highlights the value of objectively quantifying ambulatory and ED experiences soon after a visit to gain quantitative insights into these experiences. Our results do not obviate the need for subjective reports on specific experiences however both types of data can guide local and systemic improvement efforts with attention on identifying subpopulations differently affected and interventions that lower the risk for poor QOC experiences.
Disclosures: Osunkwo: Agios: Consultancy; Takeda: Consultancy; Novartis: Consultancy, Honoraria; Global Blood Therapeutics: Consultancy, Speakers Bureau; Novo Nordisk: Consultancy, Current Employment, Current equity holder in publicly-traded company, Honoraria; Forma Therapeutics: Consultancy, Ended employment in the past 24 months, Honoraria; Cheisi: Consultancy; Emmaus: Consultancy, Speakers Bureau; Acceleron: Consultancy. Desai: Chiesi: Consultancy; Novartis: Research Funding, Speakers Bureau; NIH: Research Funding; PCORI: Research Funding; University of Tennessee: Research Funding; University of Pittsburgh: Research Funding; Forma Therapeutics: Consultancy; POC Detection of Hemoglobin Sickling via Magnetic Fractionation: Patents & Royalties: (Pending); US Food & Drug Administration: Research Funding; Vertex: Consultancy. Symanowski: Astellas: Consultancy, Other: DSMB; Immatics: Consultancy, Other: DSMB; CARsgen: Consultancy, Other: DSMB; Eli Lilly: Consultancy, Other: DSMB; PCORI: Research Funding. Bryant: Novo Nordisk Rare Disease: Consultancy, Speakers Bureau; GLOVAL consulting LLC: Other: Medical Writer; Novant Health Pediatric Hematology: Ended employment in the past 24 months. Smith: Agios: Consultancy, Research Funding. Lawrence: Novo Nordisk Rare Disease: Consultancy; Forma Therapeutics: Consultancy.
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