Application-of-Path-Goal-and-Transformational-Leadership-Theory-to-Improve-Patient-and-Provider-Satisfaction-with-APP-Led-Survivorship-Care-A-Quality-Improvement-Initiative

Abstracts / Biol Blood Marrow Transplant 25 (2019) S290ÀS442 gene expression between HRV URTI and proven LRTI (Figure 1A) Differential gene expression between HRV URTI and possible LRTI was not as robust (Figure 1B) Principle component analysis of the top 500 most variable genes demonstrated separation between subjects with HRV URTI and HRV proven LRTI (Figure 2) GO enrichment analyses demonstrated enrichment of terms associated with adaptive immune responses in the URTI group (Table) Conclusions: HRV URTI and proven LRTI have highly differential gene expression patterns, whereas possible LRTI gene expression appears to more closely resemble that of URTI Gene enrichment analysis demonstrates potential increased immune activation in the URTI subjects, which may lead to better control of infection Larger studies are needed to verify these findings Whole blood RNA-seq is feasible and may be a useful tool for demonstrating unique transcriptomic signatures for clinical phenotypes in HCT recipients and for identifying specific pathways in pathogenesis Figure Differential gene expression in subjets with HRV URTI vs proven LRTI (A) and HRV URTI vs possible LRTI (B) Distance from along the x-axis represents fold change expression in LRTI groups compared to URTI (red = overexpression, green = underexpression) Distance from along y-axis represents level of signficance of differential expression Figure Principle component analysis of top 500 most variable genes demonstrates separation of subjects with HRV URTI and proven LRTI LATE EFFECTS AND QUALITY OF LIFE 561 Application of Path-Goal and Transformational Leadership Theory to Improve Patient and Provider Satisfaction with APP-Led Survivorship Care: A Quality Improvement Initiative Sasha Skendzel MSN, APRN, ACNP-BC1, Shernan G Holtan MD2, Patricia Finch-Guthrie PhD, RN3 University of Minnesota, Minneapolis, MN; Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, MN; Nursing, St Catherine University, St Paul, MN Introduction: A limited number of survivorship models have been implemented following theoretical frameworks to promote patient and provider satisfaction The purpose of this quality improvement (QI) initiative was to evaluate both parties’ satisfaction with a newly implemented advanced practice provider (APP) led survivorship visit and apply theoretical principles of Path-Goal (PG) and Transformational Leadership (TL) to enhance outcomes Methods: We surveyed a convenience sample (n = 11) of adult cancer survivors ages 36-75 undergoing survivorship visits at day 100 (n = 5) and at year (n = 6) post stem cell transplant (SCT) and APP’s (n = 7) conducting the visits following an interrupted QI design Satisfaction scores were obtained from both parties using a modified version of the validated Short Assessment of Patient Satisfaction (SAPS) Scores of > 19 were considered satisfying Additionally, 10-point Likert scales, binary, and open-ended questions were used to assess satisfaction, self-management, and survivorship care plan (SCP) utility We analyzed the data using descriptive statistics, reporting median scores and percentages for the most common results For open-ended questions, qualitative analysis was used to identify themes Results: We found patients were satisfied with the visit (median SAPS 25, range 19-28) Additionally, 100% were very satisfied with the effect of their care, found the SCP useful and reported improved post-visit self-efficacy Conversely, providers were overall dissatisfied (median SAPS 14, range 6-19) Only 28% were satisfied with care they provided and 42% were dissatisfied with their plans We also found 42% of providers and 23% of patients were dissatisfied with explanations about post-SCT risks Furthermore, 29% of providers and 36% of patients were dissatisfied with care planning decisions Conclusion: Our APP-led survivorship model was satisfying for patients However, provider satisfaction was low Both parties expressed dissatisfaction with education about post-SCT risks and decisions affecting care planning Results of a theory based provider intervention to enhance satisfaction will be presented at the 2019 Transplant and Cellular Therapies Meeting in February 2019 562 Table GO category enriched URTI GO category enriched in LRTI Regulation of immune response Cell surface receptor signaling pathway Adaptive immune response Cellular defense response T cell activation Innate immune response in mucosa Antibacterial humoral response G-protein coupled receptor signaling pathway S373 Defense response to bacterium Response to drug Defense response to gram-positive bacterium Defense response to fungus Nucleosome assembly Cardiac and Vascular Events in Patients with History of Hematopoietic STEM CELL Transplant (HSCT) Are NOT Associated with Poor Outcomes: Analysis of National Inpatient Sample 2010-2014 Karan Jatwani MD1, Shraddha Jatwani MD2, Karan Chugh MD2 Mount Sinai West - St Luke’s Hospital, New York, NY; St Vincent Evansville, Evansville, IN Background: Studies have suggested an increased risk of cardiovascular, cerebrovascular and peripheral vascular disease in patients with history of hematopoietic stem cell transplant (HSCT) (Tichelli et al, Blood 2007) This is attributed