Members of the 14C team
Members of the ​14C team: (Front, L to R) Zoe Evans, Rozan Alfar, Emily Kim, Katie Kim, Wilson Lam, Waleed Da’na. (Middle, L to R) Arjun Law, Auro Viswabandya, Rosemary Pivovarov, Dorothy Lam, Jessica Ojerio, Zarna Patel, Nee Naw, Ian Pang. (Back, L to R) Susan Clarke, David Loach, Bridgette Lord, Sara Barr. (Photo: UHN)

After months of preparation and construction, Unit 14C at the Princess Margaret Cancer Centre is open – adding 12 new beds to care for allogeneic stem cell transplant patients.

There are now 26 beds devoted to the specialized needs of these patients. The newly-renovated space will help the cancer centre increase its capacity for allogeneic transplants to 208 per year.

This is the first phase of the Princess Margaret's allogeneic expansion plan to help improve access for patients requiring transplants.

"The team is thrilled to open the doors of this new space to patients," says Susan Clarke, Nurse Manager on 14C. "Not only can we perform more transplants, but the design elements and the new staffing model are allowing us to improve the quality and safety of care, as well as improving access for this lifesaving treatment."

caring safely logoWhile the unit features an entirely new design, one element was carried over from the team's previous space – their safety huddle board.

The board is used to track opportunities to improve safety and quality on the unit, and helps the team prioritize improvements. It also gives the team the ability to celebrate completed tasks and good catches.

"It's not a unit until the safety board is up," Susan says. "It brings us together as a team every morning and the space wouldn't be complete without it."

Features of the new unit include:

  • private room model with state-of-the-art technology to control room pressurization
  • new call bell system being piloted for the Princess Margaret
  • specialized bedside equipment in several rooms (dialysis hook ups, ceiling lifts)

State of the art design

Stem cells are used to treat more than 80 different diseases and disorders, including several different types of blood cancers. An allogeneic stem cell transplant means stem cells are collected from a healthy donor and infused into a patient with a bone marrow disorder.

Patients going through this process have weakened immune systems, which puts them at greater risk of catching many different types of infections.

To minimize the chance for infection and provide safer care for patients, the unit is designed as a positive pressure unit. Patients, visitors and staff must pass through two sets of double doors to enter the unit – allowing the first set of doors to close behind them before passing through the second. This keeps the air pressure on the unit stable.

"Each patient room also has its own pressurization panel so we can make sure the air pressure in each room is at the optimal level," says Susan.

The new space and additional beds will also help decrease sending patients to other units for a longer stay due to complications post-transplant.

"We didn't have enough beds on 14B, so if the patient experienced any complications post-transplant we often had to transfer them to other malignant hematology units," Susan says.

"This new space allows patients to be cared for by the bone marrow transplant interdisciplinary team within the bone marrow transplant units."

Unique staffing model

To keep up with the increase in transplants, new nursing graduates who completed their nursing practicums at the Princess Margaret were recruited and a unique staffing model was introduced.

Physicians, Nurse Practitioners and Specialized Oncology Nurses on units 14C and 14B are now working as one interprofessional team along with other health providers, such as physio and occupational therapists, pharmacists and dietitians. Physicians have also reorganized their model of care around patient need as opposed to being unit-based. 

"Many of the registered nurses on the bone marrow transplant units are taking or have completed their transplant certification, so having this integrated staffing model ensures there is a range of experience on the unit to provide quality and safe care for patients," says Pamela Savage, Director of Professional Practice at the Princess Margaret.​

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