Historically, patients with acute myeloid leukemia received intensive chemotherapy requiring hospitalization, which can diminish quality of life and increase healthcare costs. The introduction of new therapies facilitated a shift toward outpatient therapy, which requires coordination of a multidisciplinary team, thorough patient evaluation, careful preparation and rigorous patient monitoring. Many patients are candidates for multiple treatment approaches; we generally employ CPX-351 (Vyxeos®) as an intensive outpatient approach and venetoclax (Venclyxto/Venclexta®) plus hypomethylating agents as a lower-intensity approach, with 2–3 visits/week during treatment. Treatment infusions are scheduled in the morning to leave sufficient time for transfusions and other supportive care later the same day, to prevent additional visits. With careful planning and patient monitoring, acute myeloid leukemia treatment can be successfully administered in the outpatient setting.

86 Background: In 2014, due to increased demand for inpatient hospital beds and subsequent patient dissatisfaction due to delays for patients receiving scheduled chemotherapy, Moffitt Cancer Center created a multi-disciplinary team to transition traditionally inpatient chemotherapy regimens into the outpatient setting. Methods: A Team composed of Physicians, Pharmacists, PA’s/ARNP’s, Social work, Infusion Nursing and IT drove initiation and implementation of new processes from 2014-Current with gradual increases in patient volumes and continued high quality and patient safety. Results: Over the examined 5 year time period, HyperCVAD Arm A, DA-EPOCH, Blinatumomab and Liposomal Daunorubicin and Cytarabine (Vyxeos) were transitioned into the outpatient setting. 667 total cycles of chemotherapy were transitioned into the outpatient setting, saving 4,386 inpatient days over the examined time period. Hospitalization was required in 22 of 667 cycles (3.3%) with no attributable mortality due to outpatient administration. Examination of potential financial impact was consistent with an estimated favorable impact to overall margin of $3,153,534 due to backfill of inpatient beds. Conclusions: Outpatient delivery of traditionally inpatient chemotherapy is safe and effective with the potential for reduction in delays for scheduled chemotherapy patients and favorable financial impact. Critical to success is the creation of an empowered, cross functional leadership team and a gradual and sequential approach to implementation.