| Sumario: | Significance & Background: Recently, several BiTE therapies were FDA approved for a variety of hematological and solid tumor malignancies. Community hospitals are uniquely positioned to deliver advanced cellular therapies in the outpatient setting, extending innovative treatments to a broader patient population. Purpose: To design a successful program within a community hospital setting where bispecific T-cell engagers (BiTE) therapy is safely administered using a consistent and effective process by educated staff. Interventions: Our institution applied a multidisciplinary approach with structured education and innovative care models to successfully and safely administer BiTEs, which includes: * A multidisciplinary training program to educate key hospital departments on BiTE administration, monitoring, and emergency response * Drug-specific education tailored to oncology nurses (inpatient/outpatient), intensive care unit nurses, intensivists, pharmacists, hematology lab staff, emergency department teams, advanced practice providers, and physicians * Coordination with multiple disciplines/departments, including pharmacy and the medical intensive care unit to hold a bed for BiTE patients for a 23-hour observation after the first several administrations of the drug * EMR: Admission order sets, flow sheets and smart phrases for documenting administration and adverse events (CRS and ICANS), and discharge instructions * Policies and Procedures * Patient education - extensive written materials, e.g. drug specific symptom management and a distress thermometer * Fast Pass protocol - developed for BiTE patients presenting to the emergency department with adverse reactions ensuring rapid assessment and treatment by trained staff Results: Since implementation, we have safely and effectively administered BiTE therapy to nineteen patients. We attribute the success of this program to robust education, coordinated communication, and streamlined patient management pathways. In collaboration with a dedicated hematology rounding team, we improved patient outcomes, minimized inpatient admissions, and ensured seamless care transitions. Discussion: The implementation of a structured outpatient cellular therapy program for BiTEs in a community hospital setting has demonstrated that high-quality, complex care can be effectively delivered outside of academic institutions. The success of this program serves as a blueprint for other community hospitals aiming to provide BiTE therapies, high-lighting the importance of team training, dedicated resources, and streamlined emergency response measures. Future efforts will focus on expanding indications for BiTE therapy and continuous optimization of program components based on real-time patient outcomes.
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