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Eoin Mcgrath - One of the best experts on this subject based on the ideXlab platform.
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use of the Quality Management System jacie and outcome after hematopoietic stem cell transplantation
Haematologica, 2014Co-Authors: Alois Gratwohl, Eoin Mcgrath, Anja Van Biezen, Anna Sureda, Christian Chabannon, Per Ljungman, Ronald Brand, H Baldomero, Jane F ApperleyAbstract:Competent authorities, healthcare payers and hospitals devote increasing resources to Quality Management Systems but scientific analyses searching for an impact of these Systems on clinical outcome remain scarce. Earlier data indicated a stepwise improvement in outcome after allogeneic hematopoietic stem cell transplantation with each phase of the accreditation process for the Quality Management System “JACIE”. We therefore tested the hypothesis that working towards and achieving “JACIE” accreditation would accelerate improvement in outcome over calendar time. Overall mortality of the entire cohort of 107,904 patients who had a transplant (41,623 allogeneic, 39%; 66,281 autologous, 61%) between 1999 and 2006 decreased over the 14-year observation period by a factor of 0.63 per 10 years (hazard ratio: 0.63; 0.58–0.69). Considering “JACIE“-accredited centers as those with programs having achieved accreditation by November 2012, at the latest, this improvement was significantly faster in “JACIE”-accredited centers than in non-accredited centers (approximately 5.3% per year for 49,459 patients versus approximately 3.5% per year for 58,445 patients, respectively; hazard ratio: 0.83; 0.71–0.97). As a result, relapse-free survival (hazard ratio 0.85; 0.75–0.95) and overall survival (hazard ratio 0.86; 0.76–0.98) were significantly higher at 72 months for those patients transplanted in the 162 “JACIE“-accredited centers. No significant effects were observed after autologous transplants (hazard ratio 1.06; 0.99–1.13). Hence, working towards implementation of a Quality Management System triggers a dynamic process associated with a steeper reduction in mortality over the years and a significantly improved survival after allogeneic stem cell transplantation. Our data support the use of a Quality Management System for complex medical procedures.
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use of the Quality Management System jacie and outcome after hematopoietic stem cell transplantation
Haematologica, 2014Co-Authors: Alois Gratwohl, Eoin Mcgrath, Anja Van Biezen, Anna Sureda, Christian Chabannon, Per Ljungman, Ronald Brand, H Baldomero, Jane F ApperleyAbstract:Competent authorities, healthcare payers and hospitals devote increasing resources to Quality Management Systems but scientific analyses searching for an impact of these Systems on clinical outcome remain scarce. Earlier data indicated a stepwise improvement in outcome after allogeneic hematopoietic stem cell transplantation with each phase of the accreditation process for the Quality Management System “JACIE”. We therefore tested the hypothesis that working towards and achieving “JACIE” accreditation would accelerate improvement in outcome over calendar time. Overall mortality of the entire cohort of 107,904 patients who had a transplant (41,623 allogeneic, 39%; 66,281 autologous, 61%) between 1999 and 2006 decreased over the 14-year observation period by a factor of 0.63 per 10 years (hazard ratio: 0.63; 0.58–0.69). Considering “JACIE“-accredited centers as those with programs having achieved accreditation by November 2012, at the latest, this improvement was significantly faster in “JACIE”-accredited centers than in non-accredited centers (approximately 5.3% per year for 49,459 patients versus approximately 3.5% per year for 58,445 patients, respectively; hazard ratio: 0.83; 0.71–0.97). As a result, relapse-free survival (hazard ratio 0.85; 0.75–0.95) and overall survival (hazard ratio 0.86; 0.76–0.98) were significantly higher at 72 months for those patients transplanted in the 162 “JACIE“-accredited centers. No significant effects were observed after autologous transplants (hazard ratio 1.06; 0.99–1.13). Hence, working towards implementation of a Quality Management System triggers a dynamic process associated with a steeper reduction in mortality over the years and a significantly improved survival after allogeneic stem cell transplantation. Our data support the use of a Quality Management System for complex medical procedures.
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introduction of a Quality Management System and outcome after hematopoietic stem cell transplantation
Journal of Clinical Oncology, 2011Co-Authors: Alois Gratwohl, Christian Chabannon, Per Ljungman, Ronald Brand, H Baldomero, Dietger Niederwieser, Jan J Cornelissen, Theo De Witte, Fiona Mcdonald, Eoin McgrathAbstract:Purpose A comprehensive Quality Management System called JACIE (Joint Accreditation Committee International Society for Cellular Therapy and the European Group for Blood and Marrow Transplantation), was introduced to improve Quality of care in hematopoietic stem-cell transplantation (HSCT). We therefore tested the hypothesis that the introduction of JACIE improved patient survival. Patients and Methods Data on 41,623 allogeneic (39%) and 66,281 autologous (61%) HSCTs for an acquired hematologic disorder performed between 1999 and 2007 by 421 teams in Europe were used to assess the outcomes of patients who received a transplantation at baseline ( 3 years before application or no application), during preparation (3 years before application), during application (time from application to accreditation), and after JACIE accreditation. The analysis was clustered by team and stratified for year of HSCT, donor type, disease, conditioning, and gross national income per capita of the respective country. Patient’s risks were adjusted for by their European Group for Blood and Marrow Transplantation score. Results Patient outcome was Systematically better when the transplantation center was at a more advanced phase of JACIE accreditation, independent of year of transplantation and other risk factors. Improvement was robust as quantified for relapse-free survival after allogeneic HSCT compared with baseline by a hazard ratio (HR) of 0.96 (95% CI, 0.90 to 1.03; P .22) for preparation, 0.95 (95% CI, 0.88 to 1.03; P .20) for application, and 0.86 (95% CI, 0.78 to 0.95; P .01) for the accreditation (test for trend P .01). Improvement from baseline was similar after autologous HSCT (HR for accreditation, 0.83; 95% CI, 0.74 to 0.93; P .01). Conclusion Even with all the limitations of an observational study, these findings support the hypothesis that
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introduction of a Quality Management System and outcome after hematopoietic stem cell transplantation
Journal of Clinical Oncology, 2011Co-Authors: Alois Gratwohl, Christian Chabannon, Per Ljungman, Ronald Brand, H Baldomero, Dietger Niederwieser, Jan J Cornelissen, Theo De Witte, Fiona Mcdonald, Eoin McgrathAbstract:Purpose A comprehensive Quality Management System called JACIE (Joint Accreditation Committee International Society for Cellular Therapy and the European Group for Blood and Marrow Transplantation), was introduced to improve Quality of care in hematopoietic stem-cell transplantation (HSCT). We therefore tested the hypothesis that the introduction of JACIE improved patient survival. Patients and Methods Data on 41,623 allogeneic (39%) and 66,281 autologous (61%) HSCTs for an acquired hematologic disorder performed between 1999 and 2007 by 421 teams in Europe were used to assess the outcomes of patients who received a transplantation at baseline ( 3 years before application or no application), during preparation (3 years before application), during application (time from application to accreditation), and after JACIE accreditation. The analysis was clustered by team and stratified for year of HSCT, donor type, disease, conditioning, and gross national income per capita of the respective country. Patient’s risks were adjusted for by their European Group for Blood and Marrow Transplantation score. Results Patient outcome was Systematically better when the transplantation center was at a more advanced phase of JACIE accreditation, independent of year of transplantation and other risk factors. Improvement was robust as quantified for relapse-free survival after allogeneic HSCT compared with baseline by a hazard ratio (HR) of 0.96 (95% CI, 0.90 to 1.03; P .22) for preparation, 0.95 (95% CI, 0.88 to 1.03; P .20) for application, and 0.86 (95% CI, 0.78 to 0.95; P .01) for the accreditation (test for trend P .01). Improvement from baseline was similar after autologous HSCT (HR for accreditation, 0.83; 95% CI, 0.74 to 0.93; P .01). Conclusion Even with all the limitations of an observational study, these findings support the hypothesis that
Alois Gratwohl - One of the best experts on this subject based on the ideXlab platform.
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use of the Quality Management System jacie and outcome after hematopoietic stem cell transplantation
Haematologica, 2014Co-Authors: Alois Gratwohl, Eoin Mcgrath, Anja Van Biezen, Anna Sureda, Christian Chabannon, Per Ljungman, Ronald Brand, H Baldomero, Jane F ApperleyAbstract:Competent authorities, healthcare payers and hospitals devote increasing resources to Quality Management Systems but scientific analyses searching for an impact of these Systems on clinical outcome remain scarce. Earlier data indicated a stepwise improvement in outcome after allogeneic hematopoietic stem cell transplantation with each phase of the accreditation process for the Quality Management System “JACIE”. We therefore tested the hypothesis that working towards and achieving “JACIE” accreditation would accelerate improvement in outcome over calendar time. Overall mortality of the entire cohort of 107,904 patients who had a transplant (41,623 allogeneic, 39%; 66,281 autologous, 61%) between 1999 and 2006 decreased over the 14-year observation period by a factor of 0.63 per 10 years (hazard ratio: 0.63; 0.58–0.69). Considering “JACIE“-accredited centers as those with programs having achieved accreditation by November 2012, at the latest, this improvement was significantly faster in “JACIE”-accredited centers than in non-accredited centers (approximately 5.3% per year for 49,459 patients versus approximately 3.5% per year for 58,445 patients, respectively; hazard ratio: 0.83; 0.71–0.97). As a result, relapse-free survival (hazard ratio 0.85; 0.75–0.95) and overall survival (hazard ratio 0.86; 0.76–0.98) were significantly higher at 72 months for those patients transplanted in the 162 “JACIE“-accredited centers. No significant effects were observed after autologous transplants (hazard ratio 1.06; 0.99–1.13). Hence, working towards implementation of a Quality Management System triggers a dynamic process associated with a steeper reduction in mortality over the years and a significantly improved survival after allogeneic stem cell transplantation. Our data support the use of a Quality Management System for complex medical procedures.
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use of the Quality Management System jacie and outcome after hematopoietic stem cell transplantation
Haematologica, 2014Co-Authors: Alois Gratwohl, Eoin Mcgrath, Anja Van Biezen, Anna Sureda, Christian Chabannon, Per Ljungman, Ronald Brand, H Baldomero, Jane F ApperleyAbstract:Competent authorities, healthcare payers and hospitals devote increasing resources to Quality Management Systems but scientific analyses searching for an impact of these Systems on clinical outcome remain scarce. Earlier data indicated a stepwise improvement in outcome after allogeneic hematopoietic stem cell transplantation with each phase of the accreditation process for the Quality Management System “JACIE”. We therefore tested the hypothesis that working towards and achieving “JACIE” accreditation would accelerate improvement in outcome over calendar time. Overall mortality of the entire cohort of 107,904 patients who had a transplant (41,623 allogeneic, 39%; 66,281 autologous, 61%) between 1999 and 2006 decreased over the 14-year observation period by a factor of 0.63 per 10 years (hazard ratio: 0.63; 0.58–0.69). Considering “JACIE“-accredited centers as those with programs having achieved accreditation by November 2012, at the latest, this improvement was significantly faster in “JACIE”-accredited centers than in non-accredited centers (approximately 5.3% per year for 49,459 patients versus approximately 3.5% per year for 58,445 patients, respectively; hazard ratio: 0.83; 0.71–0.97). As a result, relapse-free survival (hazard ratio 0.85; 0.75–0.95) and overall survival (hazard ratio 0.86; 0.76–0.98) were significantly higher at 72 months for those patients transplanted in the 162 “JACIE“-accredited centers. No significant effects were observed after autologous transplants (hazard ratio 1.06; 0.99–1.13). Hence, working towards implementation of a Quality Management System triggers a dynamic process associated with a steeper reduction in mortality over the years and a significantly improved survival after allogeneic stem cell transplantation. Our data support the use of a Quality Management System for complex medical procedures.
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introduction of a Quality Management System and outcome after hematopoietic stem cell transplantation
Journal of Clinical Oncology, 2011Co-Authors: Alois Gratwohl, Christian Chabannon, Per Ljungman, Ronald Brand, H Baldomero, Dietger Niederwieser, Jan J Cornelissen, Theo De Witte, Fiona Mcdonald, Eoin McgrathAbstract:Purpose A comprehensive Quality Management System called JACIE (Joint Accreditation Committee International Society for Cellular Therapy and the European Group for Blood and Marrow Transplantation), was introduced to improve Quality of care in hematopoietic stem-cell transplantation (HSCT). We therefore tested the hypothesis that the introduction of JACIE improved patient survival. Patients and Methods Data on 41,623 allogeneic (39%) and 66,281 autologous (61%) HSCTs for an acquired hematologic disorder performed between 1999 and 2007 by 421 teams in Europe were used to assess the outcomes of patients who received a transplantation at baseline ( 3 years before application or no application), during preparation (3 years before application), during application (time from application to accreditation), and after JACIE accreditation. The analysis was clustered by team and stratified for year of HSCT, donor type, disease, conditioning, and gross national income per capita of the respective country. Patient’s risks were adjusted for by their European Group for Blood and Marrow Transplantation score. Results Patient outcome was Systematically better when the transplantation center was at a more advanced phase of JACIE accreditation, independent of year of transplantation and other risk factors. Improvement was robust as quantified for relapse-free survival after allogeneic HSCT compared with baseline by a hazard ratio (HR) of 0.96 (95% CI, 0.90 to 1.03; P .22) for preparation, 0.95 (95% CI, 0.88 to 1.03; P .20) for application, and 0.86 (95% CI, 0.78 to 0.95; P .01) for the accreditation (test for trend P .01). Improvement from baseline was similar after autologous HSCT (HR for accreditation, 0.83; 95% CI, 0.74 to 0.93; P .01). Conclusion Even with all the limitations of an observational study, these findings support the hypothesis that
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introduction of a Quality Management System and outcome after hematopoietic stem cell transplantation
Journal of Clinical Oncology, 2011Co-Authors: Alois Gratwohl, Christian Chabannon, Per Ljungman, Ronald Brand, H Baldomero, Dietger Niederwieser, Jan J Cornelissen, Theo De Witte, Fiona Mcdonald, Eoin McgrathAbstract:Purpose A comprehensive Quality Management System called JACIE (Joint Accreditation Committee International Society for Cellular Therapy and the European Group for Blood and Marrow Transplantation), was introduced to improve Quality of care in hematopoietic stem-cell transplantation (HSCT). We therefore tested the hypothesis that the introduction of JACIE improved patient survival. Patients and Methods Data on 41,623 allogeneic (39%) and 66,281 autologous (61%) HSCTs for an acquired hematologic disorder performed between 1999 and 2007 by 421 teams in Europe were used to assess the outcomes of patients who received a transplantation at baseline ( 3 years before application or no application), during preparation (3 years before application), during application (time from application to accreditation), and after JACIE accreditation. The analysis was clustered by team and stratified for year of HSCT, donor type, disease, conditioning, and gross national income per capita of the respective country. Patient’s risks were adjusted for by their European Group for Blood and Marrow Transplantation score. Results Patient outcome was Systematically better when the transplantation center was at a more advanced phase of JACIE accreditation, independent of year of transplantation and other risk factors. Improvement was robust as quantified for relapse-free survival after allogeneic HSCT compared with baseline by a hazard ratio (HR) of 0.96 (95% CI, 0.90 to 1.03; P .22) for preparation, 0.95 (95% CI, 0.88 to 1.03; P .20) for application, and 0.86 (95% CI, 0.78 to 0.95; P .01) for the accreditation (test for trend P .01). Improvement from baseline was similar after autologous HSCT (HR for accreditation, 0.83; 95% CI, 0.74 to 0.93; P .01). Conclusion Even with all the limitations of an observational study, these findings support the hypothesis that
Jane F Apperley - One of the best experts on this subject based on the ideXlab platform.
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use of the Quality Management System jacie and outcome after hematopoietic stem cell transplantation
Haematologica, 2014Co-Authors: Alois Gratwohl, Eoin Mcgrath, Anja Van Biezen, Anna Sureda, Christian Chabannon, Per Ljungman, Ronald Brand, H Baldomero, Jane F ApperleyAbstract:Competent authorities, healthcare payers and hospitals devote increasing resources to Quality Management Systems but scientific analyses searching for an impact of these Systems on clinical outcome remain scarce. Earlier data indicated a stepwise improvement in outcome after allogeneic hematopoietic stem cell transplantation with each phase of the accreditation process for the Quality Management System “JACIE”. We therefore tested the hypothesis that working towards and achieving “JACIE” accreditation would accelerate improvement in outcome over calendar time. Overall mortality of the entire cohort of 107,904 patients who had a transplant (41,623 allogeneic, 39%; 66,281 autologous, 61%) between 1999 and 2006 decreased over the 14-year observation period by a factor of 0.63 per 10 years (hazard ratio: 0.63; 0.58–0.69). Considering “JACIE“-accredited centers as those with programs having achieved accreditation by November 2012, at the latest, this improvement was significantly faster in “JACIE”-accredited centers than in non-accredited centers (approximately 5.3% per year for 49,459 patients versus approximately 3.5% per year for 58,445 patients, respectively; hazard ratio: 0.83; 0.71–0.97). As a result, relapse-free survival (hazard ratio 0.85; 0.75–0.95) and overall survival (hazard ratio 0.86; 0.76–0.98) were significantly higher at 72 months for those patients transplanted in the 162 “JACIE“-accredited centers. No significant effects were observed after autologous transplants (hazard ratio 1.06; 0.99–1.13). Hence, working towards implementation of a Quality Management System triggers a dynamic process associated with a steeper reduction in mortality over the years and a significantly improved survival after allogeneic stem cell transplantation. Our data support the use of a Quality Management System for complex medical procedures.
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use of the Quality Management System jacie and outcome after hematopoietic stem cell transplantation
Haematologica, 2014Co-Authors: Alois Gratwohl, Eoin Mcgrath, Anja Van Biezen, Anna Sureda, Christian Chabannon, Per Ljungman, Ronald Brand, H Baldomero, Jane F ApperleyAbstract:Competent authorities, healthcare payers and hospitals devote increasing resources to Quality Management Systems but scientific analyses searching for an impact of these Systems on clinical outcome remain scarce. Earlier data indicated a stepwise improvement in outcome after allogeneic hematopoietic stem cell transplantation with each phase of the accreditation process for the Quality Management System “JACIE”. We therefore tested the hypothesis that working towards and achieving “JACIE” accreditation would accelerate improvement in outcome over calendar time. Overall mortality of the entire cohort of 107,904 patients who had a transplant (41,623 allogeneic, 39%; 66,281 autologous, 61%) between 1999 and 2006 decreased over the 14-year observation period by a factor of 0.63 per 10 years (hazard ratio: 0.63; 0.58–0.69). Considering “JACIE“-accredited centers as those with programs having achieved accreditation by November 2012, at the latest, this improvement was significantly faster in “JACIE”-accredited centers than in non-accredited centers (approximately 5.3% per year for 49,459 patients versus approximately 3.5% per year for 58,445 patients, respectively; hazard ratio: 0.83; 0.71–0.97). As a result, relapse-free survival (hazard ratio 0.85; 0.75–0.95) and overall survival (hazard ratio 0.86; 0.76–0.98) were significantly higher at 72 months for those patients transplanted in the 162 “JACIE“-accredited centers. No significant effects were observed after autologous transplants (hazard ratio 1.06; 0.99–1.13). Hence, working towards implementation of a Quality Management System triggers a dynamic process associated with a steeper reduction in mortality over the years and a significantly improved survival after allogeneic stem cell transplantation. Our data support the use of a Quality Management System for complex medical procedures.
Ronald Brand - One of the best experts on this subject based on the ideXlab platform.
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use of the Quality Management System jacie and outcome after hematopoietic stem cell transplantation
Haematologica, 2014Co-Authors: Alois Gratwohl, Eoin Mcgrath, Anja Van Biezen, Anna Sureda, Christian Chabannon, Per Ljungman, Ronald Brand, H Baldomero, Jane F ApperleyAbstract:Competent authorities, healthcare payers and hospitals devote increasing resources to Quality Management Systems but scientific analyses searching for an impact of these Systems on clinical outcome remain scarce. Earlier data indicated a stepwise improvement in outcome after allogeneic hematopoietic stem cell transplantation with each phase of the accreditation process for the Quality Management System “JACIE”. We therefore tested the hypothesis that working towards and achieving “JACIE” accreditation would accelerate improvement in outcome over calendar time. Overall mortality of the entire cohort of 107,904 patients who had a transplant (41,623 allogeneic, 39%; 66,281 autologous, 61%) between 1999 and 2006 decreased over the 14-year observation period by a factor of 0.63 per 10 years (hazard ratio: 0.63; 0.58–0.69). Considering “JACIE“-accredited centers as those with programs having achieved accreditation by November 2012, at the latest, this improvement was significantly faster in “JACIE”-accredited centers than in non-accredited centers (approximately 5.3% per year for 49,459 patients versus approximately 3.5% per year for 58,445 patients, respectively; hazard ratio: 0.83; 0.71–0.97). As a result, relapse-free survival (hazard ratio 0.85; 0.75–0.95) and overall survival (hazard ratio 0.86; 0.76–0.98) were significantly higher at 72 months for those patients transplanted in the 162 “JACIE“-accredited centers. No significant effects were observed after autologous transplants (hazard ratio 1.06; 0.99–1.13). Hence, working towards implementation of a Quality Management System triggers a dynamic process associated with a steeper reduction in mortality over the years and a significantly improved survival after allogeneic stem cell transplantation. Our data support the use of a Quality Management System for complex medical procedures.
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use of the Quality Management System jacie and outcome after hematopoietic stem cell transplantation
Haematologica, 2014Co-Authors: Alois Gratwohl, Eoin Mcgrath, Anja Van Biezen, Anna Sureda, Christian Chabannon, Per Ljungman, Ronald Brand, H Baldomero, Jane F ApperleyAbstract:Competent authorities, healthcare payers and hospitals devote increasing resources to Quality Management Systems but scientific analyses searching for an impact of these Systems on clinical outcome remain scarce. Earlier data indicated a stepwise improvement in outcome after allogeneic hematopoietic stem cell transplantation with each phase of the accreditation process for the Quality Management System “JACIE”. We therefore tested the hypothesis that working towards and achieving “JACIE” accreditation would accelerate improvement in outcome over calendar time. Overall mortality of the entire cohort of 107,904 patients who had a transplant (41,623 allogeneic, 39%; 66,281 autologous, 61%) between 1999 and 2006 decreased over the 14-year observation period by a factor of 0.63 per 10 years (hazard ratio: 0.63; 0.58–0.69). Considering “JACIE“-accredited centers as those with programs having achieved accreditation by November 2012, at the latest, this improvement was significantly faster in “JACIE”-accredited centers than in non-accredited centers (approximately 5.3% per year for 49,459 patients versus approximately 3.5% per year for 58,445 patients, respectively; hazard ratio: 0.83; 0.71–0.97). As a result, relapse-free survival (hazard ratio 0.85; 0.75–0.95) and overall survival (hazard ratio 0.86; 0.76–0.98) were significantly higher at 72 months for those patients transplanted in the 162 “JACIE“-accredited centers. No significant effects were observed after autologous transplants (hazard ratio 1.06; 0.99–1.13). Hence, working towards implementation of a Quality Management System triggers a dynamic process associated with a steeper reduction in mortality over the years and a significantly improved survival after allogeneic stem cell transplantation. Our data support the use of a Quality Management System for complex medical procedures.
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introduction of a Quality Management System and outcome after hematopoietic stem cell transplantation
Journal of Clinical Oncology, 2011Co-Authors: Alois Gratwohl, Christian Chabannon, Per Ljungman, Ronald Brand, H Baldomero, Dietger Niederwieser, Jan J Cornelissen, Theo De Witte, Fiona Mcdonald, Eoin McgrathAbstract:Purpose A comprehensive Quality Management System called JACIE (Joint Accreditation Committee International Society for Cellular Therapy and the European Group for Blood and Marrow Transplantation), was introduced to improve Quality of care in hematopoietic stem-cell transplantation (HSCT). We therefore tested the hypothesis that the introduction of JACIE improved patient survival. Patients and Methods Data on 41,623 allogeneic (39%) and 66,281 autologous (61%) HSCTs for an acquired hematologic disorder performed between 1999 and 2007 by 421 teams in Europe were used to assess the outcomes of patients who received a transplantation at baseline ( 3 years before application or no application), during preparation (3 years before application), during application (time from application to accreditation), and after JACIE accreditation. The analysis was clustered by team and stratified for year of HSCT, donor type, disease, conditioning, and gross national income per capita of the respective country. Patient’s risks were adjusted for by their European Group for Blood and Marrow Transplantation score. Results Patient outcome was Systematically better when the transplantation center was at a more advanced phase of JACIE accreditation, independent of year of transplantation and other risk factors. Improvement was robust as quantified for relapse-free survival after allogeneic HSCT compared with baseline by a hazard ratio (HR) of 0.96 (95% CI, 0.90 to 1.03; P .22) for preparation, 0.95 (95% CI, 0.88 to 1.03; P .20) for application, and 0.86 (95% CI, 0.78 to 0.95; P .01) for the accreditation (test for trend P .01). Improvement from baseline was similar after autologous HSCT (HR for accreditation, 0.83; 95% CI, 0.74 to 0.93; P .01). Conclusion Even with all the limitations of an observational study, these findings support the hypothesis that
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introduction of a Quality Management System and outcome after hematopoietic stem cell transplantation
Journal of Clinical Oncology, 2011Co-Authors: Alois Gratwohl, Christian Chabannon, Per Ljungman, Ronald Brand, H Baldomero, Dietger Niederwieser, Jan J Cornelissen, Theo De Witte, Fiona Mcdonald, Eoin McgrathAbstract:Purpose A comprehensive Quality Management System called JACIE (Joint Accreditation Committee International Society for Cellular Therapy and the European Group for Blood and Marrow Transplantation), was introduced to improve Quality of care in hematopoietic stem-cell transplantation (HSCT). We therefore tested the hypothesis that the introduction of JACIE improved patient survival. Patients and Methods Data on 41,623 allogeneic (39%) and 66,281 autologous (61%) HSCTs for an acquired hematologic disorder performed between 1999 and 2007 by 421 teams in Europe were used to assess the outcomes of patients who received a transplantation at baseline ( 3 years before application or no application), during preparation (3 years before application), during application (time from application to accreditation), and after JACIE accreditation. The analysis was clustered by team and stratified for year of HSCT, donor type, disease, conditioning, and gross national income per capita of the respective country. Patient’s risks were adjusted for by their European Group for Blood and Marrow Transplantation score. Results Patient outcome was Systematically better when the transplantation center was at a more advanced phase of JACIE accreditation, independent of year of transplantation and other risk factors. Improvement was robust as quantified for relapse-free survival after allogeneic HSCT compared with baseline by a hazard ratio (HR) of 0.96 (95% CI, 0.90 to 1.03; P .22) for preparation, 0.95 (95% CI, 0.88 to 1.03; P .20) for application, and 0.86 (95% CI, 0.78 to 0.95; P .01) for the accreditation (test for trend P .01). Improvement from baseline was similar after autologous HSCT (HR for accreditation, 0.83; 95% CI, 0.74 to 0.93; P .01). Conclusion Even with all the limitations of an observational study, these findings support the hypothesis that
H Baldomero - One of the best experts on this subject based on the ideXlab platform.
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use of the Quality Management System jacie and outcome after hematopoietic stem cell transplantation
Haematologica, 2014Co-Authors: Alois Gratwohl, Eoin Mcgrath, Anja Van Biezen, Anna Sureda, Christian Chabannon, Per Ljungman, Ronald Brand, H Baldomero, Jane F ApperleyAbstract:Competent authorities, healthcare payers and hospitals devote increasing resources to Quality Management Systems but scientific analyses searching for an impact of these Systems on clinical outcome remain scarce. Earlier data indicated a stepwise improvement in outcome after allogeneic hematopoietic stem cell transplantation with each phase of the accreditation process for the Quality Management System “JACIE”. We therefore tested the hypothesis that working towards and achieving “JACIE” accreditation would accelerate improvement in outcome over calendar time. Overall mortality of the entire cohort of 107,904 patients who had a transplant (41,623 allogeneic, 39%; 66,281 autologous, 61%) between 1999 and 2006 decreased over the 14-year observation period by a factor of 0.63 per 10 years (hazard ratio: 0.63; 0.58–0.69). Considering “JACIE“-accredited centers as those with programs having achieved accreditation by November 2012, at the latest, this improvement was significantly faster in “JACIE”-accredited centers than in non-accredited centers (approximately 5.3% per year for 49,459 patients versus approximately 3.5% per year for 58,445 patients, respectively; hazard ratio: 0.83; 0.71–0.97). As a result, relapse-free survival (hazard ratio 0.85; 0.75–0.95) and overall survival (hazard ratio 0.86; 0.76–0.98) were significantly higher at 72 months for those patients transplanted in the 162 “JACIE“-accredited centers. No significant effects were observed after autologous transplants (hazard ratio 1.06; 0.99–1.13). Hence, working towards implementation of a Quality Management System triggers a dynamic process associated with a steeper reduction in mortality over the years and a significantly improved survival after allogeneic stem cell transplantation. Our data support the use of a Quality Management System for complex medical procedures.
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use of the Quality Management System jacie and outcome after hematopoietic stem cell transplantation
Haematologica, 2014Co-Authors: Alois Gratwohl, Eoin Mcgrath, Anja Van Biezen, Anna Sureda, Christian Chabannon, Per Ljungman, Ronald Brand, H Baldomero, Jane F ApperleyAbstract:Competent authorities, healthcare payers and hospitals devote increasing resources to Quality Management Systems but scientific analyses searching for an impact of these Systems on clinical outcome remain scarce. Earlier data indicated a stepwise improvement in outcome after allogeneic hematopoietic stem cell transplantation with each phase of the accreditation process for the Quality Management System “JACIE”. We therefore tested the hypothesis that working towards and achieving “JACIE” accreditation would accelerate improvement in outcome over calendar time. Overall mortality of the entire cohort of 107,904 patients who had a transplant (41,623 allogeneic, 39%; 66,281 autologous, 61%) between 1999 and 2006 decreased over the 14-year observation period by a factor of 0.63 per 10 years (hazard ratio: 0.63; 0.58–0.69). Considering “JACIE“-accredited centers as those with programs having achieved accreditation by November 2012, at the latest, this improvement was significantly faster in “JACIE”-accredited centers than in non-accredited centers (approximately 5.3% per year for 49,459 patients versus approximately 3.5% per year for 58,445 patients, respectively; hazard ratio: 0.83; 0.71–0.97). As a result, relapse-free survival (hazard ratio 0.85; 0.75–0.95) and overall survival (hazard ratio 0.86; 0.76–0.98) were significantly higher at 72 months for those patients transplanted in the 162 “JACIE“-accredited centers. No significant effects were observed after autologous transplants (hazard ratio 1.06; 0.99–1.13). Hence, working towards implementation of a Quality Management System triggers a dynamic process associated with a steeper reduction in mortality over the years and a significantly improved survival after allogeneic stem cell transplantation. Our data support the use of a Quality Management System for complex medical procedures.
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introduction of a Quality Management System and outcome after hematopoietic stem cell transplantation
Journal of Clinical Oncology, 2011Co-Authors: Alois Gratwohl, Christian Chabannon, Per Ljungman, Ronald Brand, H Baldomero, Dietger Niederwieser, Jan J Cornelissen, Theo De Witte, Fiona Mcdonald, Eoin McgrathAbstract:Purpose A comprehensive Quality Management System called JACIE (Joint Accreditation Committee International Society for Cellular Therapy and the European Group for Blood and Marrow Transplantation), was introduced to improve Quality of care in hematopoietic stem-cell transplantation (HSCT). We therefore tested the hypothesis that the introduction of JACIE improved patient survival. Patients and Methods Data on 41,623 allogeneic (39%) and 66,281 autologous (61%) HSCTs for an acquired hematologic disorder performed between 1999 and 2007 by 421 teams in Europe were used to assess the outcomes of patients who received a transplantation at baseline ( 3 years before application or no application), during preparation (3 years before application), during application (time from application to accreditation), and after JACIE accreditation. The analysis was clustered by team and stratified for year of HSCT, donor type, disease, conditioning, and gross national income per capita of the respective country. Patient’s risks were adjusted for by their European Group for Blood and Marrow Transplantation score. Results Patient outcome was Systematically better when the transplantation center was at a more advanced phase of JACIE accreditation, independent of year of transplantation and other risk factors. Improvement was robust as quantified for relapse-free survival after allogeneic HSCT compared with baseline by a hazard ratio (HR) of 0.96 (95% CI, 0.90 to 1.03; P .22) for preparation, 0.95 (95% CI, 0.88 to 1.03; P .20) for application, and 0.86 (95% CI, 0.78 to 0.95; P .01) for the accreditation (test for trend P .01). Improvement from baseline was similar after autologous HSCT (HR for accreditation, 0.83; 95% CI, 0.74 to 0.93; P .01). Conclusion Even with all the limitations of an observational study, these findings support the hypothesis that
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introduction of a Quality Management System and outcome after hematopoietic stem cell transplantation
Journal of Clinical Oncology, 2011Co-Authors: Alois Gratwohl, Christian Chabannon, Per Ljungman, Ronald Brand, H Baldomero, Dietger Niederwieser, Jan J Cornelissen, Theo De Witte, Fiona Mcdonald, Eoin McgrathAbstract:Purpose A comprehensive Quality Management System called JACIE (Joint Accreditation Committee International Society for Cellular Therapy and the European Group for Blood and Marrow Transplantation), was introduced to improve Quality of care in hematopoietic stem-cell transplantation (HSCT). We therefore tested the hypothesis that the introduction of JACIE improved patient survival. Patients and Methods Data on 41,623 allogeneic (39%) and 66,281 autologous (61%) HSCTs for an acquired hematologic disorder performed between 1999 and 2007 by 421 teams in Europe were used to assess the outcomes of patients who received a transplantation at baseline ( 3 years before application or no application), during preparation (3 years before application), during application (time from application to accreditation), and after JACIE accreditation. The analysis was clustered by team and stratified for year of HSCT, donor type, disease, conditioning, and gross national income per capita of the respective country. Patient’s risks were adjusted for by their European Group for Blood and Marrow Transplantation score. Results Patient outcome was Systematically better when the transplantation center was at a more advanced phase of JACIE accreditation, independent of year of transplantation and other risk factors. Improvement was robust as quantified for relapse-free survival after allogeneic HSCT compared with baseline by a hazard ratio (HR) of 0.96 (95% CI, 0.90 to 1.03; P .22) for preparation, 0.95 (95% CI, 0.88 to 1.03; P .20) for application, and 0.86 (95% CI, 0.78 to 0.95; P .01) for the accreditation (test for trend P .01). Improvement from baseline was similar after autologous HSCT (HR for accreditation, 0.83; 95% CI, 0.74 to 0.93; P .01). Conclusion Even with all the limitations of an observational study, these findings support the hypothesis that
