Cancer & Blood Disorders Quality Improvements

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:

• Improve communication of chemotherapy being delivered to Hematology/Oncology clinic and inpatient floor by the pharmacy

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 clean central line and dressing
• Maintain good oral hygiene
• Maintain clean environment/patient rooms and bathrooms

Next Steps:

Start antibiotics in individuals at high risk for blood infections during chemotherapy to try to prevent these infections

Prompt antibiotic administration 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 clinic (OP) at the Akron and Beeghly Campuses or observation unit (IP) and >80% of the time in the Akron Children’s Hospital Emergency Departments (ED)

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:

Decrease the time it takes to have the antibiotics given to the patients once it is available to the nursing team

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

Goal: To have 100% of patients who have undergone either an autologous donor (patient donated stem cells to themselves) or allogeneic donor (somebody other than the patient donated stem cells to the patient) bone marrow transplant restart vaccinations within 2 months of when they are considered safe to restart

Actions:

• Develop a patient vaccine schedule based on previous schedule developed by experts who specialize in vaccine medicine
• Place a tool within the medical record in order to keep track of the patient’s vaccine schedule

Next Steps:

• Develop a way to notify the medical team when a patient is able to start the vaccine schedule