| Facility |
Ensure insurance authorization for BsAb and supportive care medications (including tocilizumab), if applicable Ensure there is a facility with tocilizumab available within close radius of patient’s location with a minimum of 2 doses of tocilizumab available for immediate use Ensure that clinic staff including registered nurses, pharmacists, and providers are aware of tocilizumab location and how to administer Designated location (clinic/infusion center) for patients to be treated outpatient if concerns for grade 1 or, in unique instances, grade 2 CRS Institutions should have dedicated pathways for escalating care for patients with grade 2 CRS not responsive to outpatient management or for patients with more severe CRS Use electronic medical records, if available, to create standard order sets for CRS management or acute care plans
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| Personnel |
Provide education to staff involvement in administration, monitoring, and management of toxicities associated with BsAbs Appoint a dedicated health care team (eg, oncologist, advanced practice provider, nurse, and pharmacist) to monitor and manage complications. This can be the same team or a rotating team depending on institution capabilities.
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| Patient resources |
Ensure patients have access to a thermometer. This can be provided by the health care facility or purchased by the patient. Blood pressure cuff and pulse oximeter can also be helpful if available to the patient. Encourage patients to have educational sheet completed (Figure 1) Prescription for dexamethasone to use as needed for CRS. Patients should be instructed to administer only after discussing with care team. Ideally patients should remain near a facility that stocks tocilizumab during the treatment days with highest risk for development of CRS
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| Patient and caregiver education |
Overview of BsAbs and most common toxicities Provide education on home monitoring of vitals and symptoms Provide clear indications to call the care team Provide necessary contact information
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