Eliminating Additional Central Venous Catheter CVC Insertion in Allogenic Hematopoietic Stem Cell Transplant
Care Process & Redesign
Singapore Healthcare Management Congress
National University Health System
11 February 2026
This project aims to eliminate CVC usage for allogenic PBSC infusion within 6 months, improving patient experience and. PICC usage for PBSC infusion in allogenic HSCT patients is safe and effective, improving operational efficiency, enhancing patient.
Year Submitted: 2025
Published Date: 11 February 2026
Tags: Care Process ＆ Redesign, Cost Saving, Workflow Redesign, Quality Improvement, Value Based Care, Patient Reported Experience Measures, Risk Management, Safe Care
About this Content
Aims
This project aims to eliminate CVC usage for allogenic PBSC infusion within 6 months, improving patient experience and reducing costs.
Background
All patients undergoing allogeneic haematopoietic stem cell transplant (alloHSCT) have an existing functional peripherally inserted central catheter (PICC) for chemotherapy and transfusion administration. Despite this, due to limited data in the literature on engraftment when using PICC for stem cell infusions, these patients will have an additional central venous catheter (CVC) inserted through the internal jugular vein for their peripheral blood stem cell (PBSC) infusions. This results in extra cost and unnecessary risks of line-related complications for them.
Methods
Conducted literature review on PICC for PBSC infusion, implemented change control practice within NUH HSCT program, developed standardized nursing checklist & workflow for PICC in alloHST, pilot study with 21 HSCT cases using PICC to evaluate feasibility & engraftment outcomes, educated nursing staff, transplant nurses, coordinators and doctors on new workflow, monitored CVC usage rate for alloHSCT over 10 months, conducted lab-based validation on PICC for PBSC infusion.
Results
1. Eliminated CVC usage for allogenic HSCT infusion within 6 months. 2. Maintained 0% CVC usage for 6 consecutive months, resulting in zero CVC-related complications. 3. The pilot study of 21 patients showed no infusion or catheter-related complications, with median time to neutrophil and platelet recovery comparable to historical cohort data. 4. Achieved a 53% reduction in costs saving (from $1,486 for CVC+PICC to $698 for PICC alone) between November 2023 and August 2024. 5. Improved patient experience by eliminating the need for an additional invasive procedure and reducing discomfort associated with CVC insertion
Conclusion
PICC usage for PBSC infusion in allogenic HSCT patients is safe and effective, improving operational efficiency, enhancing patient experience, reducing costs, and minimizing risks
Lessons Learnt
The initiative demonstrated PICC's safe and effective use for PBSC infusion in allogenic HSCT patients. It improved operational efficiency, enhanced patient experience, reduced costs, and minimized risks.
Keywords
PICC, CVC, HSCT, cost saving, patient experience
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National University Health System |
Organization(s) Involved | National University Cancer Institute, Singapore |
Platform(s) | Singapore Healthcare Management Congress |
Healthcare Professional Group(s) | Nursing |
Applicable Specialty or Discipline | Oncology |
Project Lead(s) | Yu Ting Ngo |
Project Member(s) | Yahui Wei |
Connect with this contributor!
Singapore Healthcare Management Secretariat - singaporehealthcaremanagement@singhealth.com.sg