BC Cancer Victoria
Pilot project with Hospital at Home supporting melanoma patients in the Victoria area

Preamble

Hospital at Home (HaH) is collaborating with BC Cancer Victoria on a pilot project supporting melanoma patients in the Greater Victoria area.

Eligible oncology patients will be offered a new bispectific T-cell engager at BC Cancer Victoria. This forth line treatment option has a high risk of immune related toxicities, namely cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). Close monitoring of these symptoms is essential with immediate interventions should a medication reaction occur.

Process

Patients will be identified and offered this treatment option at BC Cancer Victoria. To participate in this pilot project, patients will be required to:

(1) live within a 30-minute drive time from the Royal Jubilee Hospital and,

(2) have a caregiver / family member support them during this treatment timeframe.

Patients will be admitted into the RJH Hospital at Home (HaH) unit. Over an eight-day window of time, the patient will receive three doses of the bispecific T-cell engager treatment. This treatment will be administered at BC Cancer Victoria in the outpatient clinic. Following treatment at BC Cancer, the patient will return home where they are monitored by the Hospital at Home team. As patients participating in this pilot project may live across Vancouver Island, his / her “home” environment may include any form of permanent or temporary accommodation (detached home, townhouse, apartment, rental suite, hotel, motel, BC Cancer Lodge).

The HaH team will be monitoring these patients 24/7 following treatment administration.

Should the patient exhibit signs of an adverse reaction:

❑ hypoxemia

❑ hypotension

❑ fever and/or

❑ neurological changes such as encephalopath

The caregiver/family member will be instructed to call 9-1-1.

Destination Guideline

The default destination for all patients participating in this pilot project will be Royal Jubilee Hospital Emergency Department. Patient will require immediate transfer as therapeutic interventions are required within 60 minutes of symptom onset.

Task	Most Responsible	Additional
Melanoma patient identified for pilot	BC Cancer Physician lead
Patient screened / meets HaH criteria	HaH CNL	BC Cancer Physician Lead
Patient agrees to participate / signs consent	HaH CNL	HaH RN
Patient treatment plan determined – example: Admission – Sunday Treatment – Monday Treatment – Wednesday Treatment – Friday Discharge – Sunday	BC Cancer physician	BC Cancer booking clerk
Patient treatment plan communicated to HaH Physician and HaH CNL	BC Cancer physician	BC Cancer booking clerk
Patient information, including address, is entered into HaH email template     * Temporary Address (location) noted, including suite number / hotel number	HaH CNL	HaH NUA
Email template is sent to BCEHS (Glen Polson) for address flagging (8 day window) – Sunday to Sunday	HaH CNL	HaH NUA
HaH patient address is entered into 9-1-1 dispatch mapping, indicating default destination	BCEHS (Glen Polson)	BCEHS – 9-1-1 clerk
On admission to HaH pilot project, provide patient with laminated:     * Pocket card for patient     * Quick reference for fridge     * Emergency pathway-911	HaH RN

Review Schedule

Adopted	Next Review Scheduled	Owner	Reviewer
OCT 2026	APR 2027	Clinical Ops-Victoria	Glen Polson