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Cancer & Blood Disorders Quality Improvements

Akron Children’s is committed to maintaining and improving the quality and safety of our care. We collaborate with other groups, accrediting bodies and pediatric hospitals on quality improvement initiatives to create and maintain the highest standards of pediatric care.

The Division of Hematology-Oncology has had an active quality improvement committee since 2006. The team, which meets monthly, includes a dozen staff members from various disciplines. Here is a summary of the current projects.

Reduce Errors Relating To Ordering Chemotherapy

Includes data through 6/1/2020

Reduce Errors Relating to Ordering Chemotherapy

Goal: Decrease the number of potentially harmful chemotherapy errors to less than 15% of all chemotherapy related errors

Actions:

  • Daily chemotherapy team meeting
  • Two care providers review all chemotherapy medication orders
  • Pharmacy review of all chemotherapy orders 48 hours prior to being given to patients

Next Steps:

  • Change metric goal from percentage to an absolute number of errors
Reduce Central Line-Associated Blood Stream Infections (CLA-BSI)

Includes data through 6/1/2020

Reduce Central Line-Associated Blood Stream Infections (CLA-BSI)

Goal: To have a Hematology/Oncology inpatient CLA-BSI rate (number of blood infections per 1000 days with central lines) below the national rate

Actions:

  • Maintain high level of reliability in carrying out standard maintenance central line care
  • Maintain good oral hygiene
  • Maintain clean environment/patient rooms and bathrooms

Next Steps:

  • Participate in testing new intervention in coming year through Solutions for Patient Safety
Prompt antibiotic administration Hem-Onc Clinic

Includes data up through 6/1/2021

Prompt antibiotic administration in OP clinic to patients with cancer or sickle cell disease who have fever

Goal: Patients with fever and either cancer or sickle cell disease will have antibiotics given within 1 hour upon arrival >95% of the time in the Hematology/Oncology Outpatient Clinic at the Akron and Beeghly Campuses

Actions:

  • A system in electronic medical record to alert the medical team
  • An easy way to enter orders rapidly
  • Having antibiotics available in these locations at all times

Next Steps:

  • Launch Patient Timer Initiative – timer to start at patient arrival for all team members to be aware of time remaining for administration
  • Collaborate with Akron Children's Hospital Sepsis Initiative in the Emergency Department

 

Prompt antibiotic admin hem-onc patients in obs unit

Includes data up through 6/1/2021

Prompt antibiotic administration in observation unit to patients with cancer or sickle cell disease who have fever

Goal: Patients with fever and either cancer or sickle cell disease will have antibiotics given within 1 hour upon arrival >95% of the time in the Observation unit at the Akron and Beeghly Campuses

Actions:

  • A system in electronic medical record to alert the medical team
  • An easy way to enter orders rapidly
  • Having antibiotics available in these locations at all times

Next Steps:

  • Launch Patient Timer Initiative – timer to start at patient arrival for all team members to be aware of time remaining for administration
  • Collaborate with Akron Children's Hospital Sepsis Initiative in the Emergency Department
Prompt antibiotic administration hem-onc patients in ER

Includes data up through 6/1/2021

Prompt antibiotic administration in ER to patients with cancer or sickle cell disease who have fever

Goal: Patients with fever and either cancer or sickle cell disease will have antibiotics given within 1 hour upon arrival  >80% of the time in the Akron Children’s Hospital Emergency Departments

Actions:

  • A system in electronic medical record to alert the medical team
  • An easy way to enter orders rapidly
  • Having antibiotics available in these locations at all times

Next Steps:

  • Launch Patient Timer Initiative – timer to start at patient arrival for all team members to be aware of time remaining for administration
  • Collaborate with Akron Children's Hospital Sepsis Initiative in the Emergency Department
Vaccine Administration

Administer vaccines to children and young adults following bone marrow/stem cell transplantation in a timely fashion

Goal: To have >95% of patients who are actively undergoing therapy for cancer receive their annual influenza vaccine

Actions:

  • Have vaccine readily available in Hematology/Oncology clinic and inpatient services
  • Utilize automated report to alert staff and providers when patients are due for a vaccine

Next Steps:

  • Continue to promote the benefits of receiving the annual influenza vaccine in individuals at risk of more severe disease.