Enhancing patient safety and experience using a multidisciplinary standard operating procedure (SOP) for the subcutaneous allergen immunotherapy (SCIT) pathway
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Authors
Tay J.
Tan R.M.
Salvador L.C.
Bidder T.
Chen C.
De Leon A.
TangoAn M.A.
Britt C.
Fernandes B.
Burgaleta R.M.
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2025
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Objectives: Subcutaneous allergen immunotherapy (SCIT) is resource-intensive treatment. Successful implementation requires collaboration from multidisciplinary team (MDT) members. We developed and implemented an MDT-SCIT standardised operating procedure (SOP) to improve patient safety and experience. Method(s): The SCIT service in our trust was run without a formal SOP. Monitoring was unstandardised and patient satisfaction was not captured. Our MDT created an SOP from immunotherapy approval to initiation and monitoring. Nurse-led clinics for pre-SCIT counselling and immunotherapy review were embedded as well as MDT meeting presentation of all new starters and annual reviews. A rolling quarterly anonymised Patient Satisfaction Questionnaire (PSQ) was commenced. Individual patients were surveyed only annually. We compared incidents/near-misses reported via Datix, pre-and post-SOP launch (April 2024 to April 2025). Result(s): 16/18 (89%) patients in the first patient cohort participated. 10 questions were rated using a 5-point Likert scale. 100% of responders 'totally agreed' they had a satisfactory experience; 88% would recommend SCIT. However, only 72% of patients were satisfied with the booking process; only 69% were satisfied with how side effects were dealt with. 6% of patients felt they did not receive enough information beforehand; 90% knew the team's contact details (vs <70%); 88% agreed side effects were managed appropriately (vs 69%). From April to October 2024, 3 incidents were recorded-1 involved an incorrect dose administered, while 2 were related to expired product use. No incidents/near-misses have been reported since November 2024. Conclusion(s): The development of an MDT-SCIT SOP has improved overall patient experience and safety. Future plans include virtual patient engagement events and clinical audit to measure adherence to the SOP.
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Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology