Token economy to improve adherence to activities of daily living

Background Participation in key activities of daily living (ADL), including daily bathing, physical activity, and oral hygiene can decrease the risk of bloodstream infections, oral complications, and deconditioning in pediatric patients undergoing hematopoietic stem cell transplant (HSCT). However, many patients fail to perform ADL during their inpatient stay. To improve inpatient adherence to ADL, we tested a token economy to engage patients, families and the clinical team in improving adherence to these important health behaviors during this critical time.