Quality Improvement Interventions across a Network of Pediatric Hematology-Oncology Clinics

Area of Science:

• Pediatric Hematology-Oncology
• Infectious Disease Prevention
• Quality Improvement Science

Background:

• Pediatric hematology-oncology patients, particularly those with febrile neutropenia, face high risks of severe infections.
• Central line-associated bloodstream infections (CLABSIs) are a significant concern for immunocompromised children with implanted catheters.
• A network of 8 pediatric hematology-oncology clinics initiated quality improvement programs to combat infection incidence and treatment delays.

Purpose of the Study:

• To assess the impact of targeted quality improvement initiatives on infection rates and treatment timeliness in pediatric hematology-oncology patients.
• To evaluate the effectiveness of early antibiotic administration and central line care bundles in reducing infections.

Main Methods:

• A retrospective review of antibiotic administration timing for febrile immunocompromised patients before and after intervention.
• Analysis of central line-associated bloodstream infection (CLABSI) rates before and after the implementation of a central line care bundle for ambulatory patients with implanted catheters.

Main Results:

• Antibiotic administration within 60 minutes of registration improved significantly, rising from 23% pre-intervention to 53% and 73% in subsequent periods.
• Implementation of a central line bundle for implanted catheters demonstrated increased compliance and a positive trend toward longer intervals between CLABSIs.

Conclusions:

• A multi-institutional quality improvement strategy involving monitoring, audits, joint initiatives, and staff training can effectively enhance patient care.
• The described approach facilitates sustainable improvements in healthcare delivery across a network of clinical sites.