Multi-Institution Harmonization of Infection Care Pathways for Pediatric Oncology

Area of Science:

• Pediatric Oncology
• Infectious Diseases
• Healthcare Management

Background:

• Care pathways bridge evidence-based guidelines and clinical practice.
• Institution-specific pathways for infection management in pediatric oncology were developed across four Canadian institutions.
• A project was initiated to standardize these care pathways across institutions.

Purpose of the Study:

• To harmonize institution-specific care pathways for managing infection complications in pediatric oncology.
• To standardize care delivery approaches for pediatric cancer patients across multiple institutions.

Main Methods:

• Comparative analysis of institution-specific infection care pathways.
• Identification and prioritization of 33 care pathway components for harmonization.
• In-person and virtual meetings with institutional representatives to discuss and finalize harmonization plans, using a five-point Likert scale for feasibility assessment.

Main Results:

• Harmonization was achieved for 25 out of 33 care pathway components.
• Eight of ten components related to antibacterial and antifungal prophylaxis were harmonized.
• Eleven of sixteen components for febrile neutropenia management and six of seven for prolonged fever were harmonized.

Conclusions:

• Successful harmonization of infection care pathways across institutions was achieved.
• Certain elements may resist harmonization due to variations in institutional resources, cultures, and priorities.