Guiding the Standardization in Acute Leukemia Service Delivery through the Development of Organizational Requirements

Introduction: In Ontario, Canada, acute leukemia (AL) care is delivered to patients at three levels of specialized service provider sites: 1) Transplant and AL Service Sites, providing all services, including stem cell transplant, chimeric antigen receptor T-cell therapy, and high intensity chemotherapy (e.g., induction); 2) AL Service Sites, providing a subset of services, including high intensity chemotherapy; and 3) AL Shared-Care Partner Centres providing consolidation and less intense chemotherapy, supportive care and follow-up. Sites and healthcare are government funded, through a single-payer system. In 2017, Cancer Care Ontario (now a part of Ontario Health), the government agency managing the delivery of cancer services, released the Acute Leukemia Provincial Plan to provide a vision for the delivery of timely access to high-quality, coordinated services for patients with AL in Ontario. Working with the 14 Regional Cancer Programs in the province, a 10-year plan for expansion to meet the expected demand was developed. Subsequently, provincial stakeholders, including clinical and administrative leaders from across the Province identified a need to develop guidance to ensure all provider sites (existing, new and in development) have the same infrastructure, expertise, quality management, and policies and procedures necessary to deliver high quality care for this specialized, high-need patient population.