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

Includes data through November, 2022

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 through April 2023

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:

  • Conduct focus group with hem/onc staff to characterize successes
Prompt antibiotic administration hem-onc patients in ER

Includes data through April, 2023

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 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:

  • Re-evaluate use of patient timer initiative in the ER
  • Education with ER staff regarding best practices for port access
Low-Risk Fever and Neutropenia Pathway

Enroll Eligible Patients on Low-Risk Fever and Neutropenia Pathway

Goal: Decrease unnecessary admissions for fever and neutropenia thereby decreasing the admission burden on patients and decreasing antibiotic exposure

Action items:

  • Protocol in place to determine which patients are eligible for pathway
  • Dot phrase used to ensure that patients and families have appropriate discharge instructions and follow up

Next steps:

  • Perform cost savings analysis
Vaccine Administration

Includes data through 2022

Increase the number of Oncology patients receiving the influenza vaccine

Goal: To have >90% 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.

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