Sustained reductions in time to antibiotic delivery in febrile immunocompromised children: results of a quality improvement collaborative

BMJ Quality & Safety
Christopher E DandoyEvaline Alessandrini

Abstract

Timely delivery of antibiotics to febrile immunocompromised (F&I) paediatric patients in the emergency department (ED) and outpatient clinic reduces morbidity and mortality. The aim of this quality improvement initiative was to increase the percentage of F&I patients who received antibiotics within goal in the clinic and ED from 25% to 90%. Using the Model of Improvement, we performed Plan-Do-Study-Act cycles to design, test and implement high-reliability interventions to decrease time to antibiotics. Pre-arrival interventions were tested and implemented, followed by post-arrival interventions in the ED. Many processes were spread successfully to the outpatient clinic. The Chronic Care Model was used, in addition to active family engagement, to inform and improve processes. The study period was from January 2010 to January 2015. Pre-arrival planning improved our F&I time to antibiotics in the ED from 137 to 88 min. This was sustained until October 2012, when further interventions including a pre-arrival huddle decreased the median time to <50 min. Implementation of the various processes to the clinic delivery system increased the mean percentage of patients receiving antibiotics within 60 min to >90%. In September 2014, we impl...Continue Reading

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Citations

Jun 7, 2018·Journal of Pediatric Oncology Nursing : Official Journal of the Association of Pediatric Oncology Nurses·Katrina J AndersonJulia E Clark
Aug 7, 2018·American Journal of Medical Quality : the Official Journal of the American College of Medical Quality·Beth L EmersonAntonio Riera
Apr 25, 2019·Hospital Pediatrics·Nafeh FananapazirSelena Hariharan
Feb 10, 2021·Journal of General Internal Medicine·Camilla B PimentelChristine W Hartmann
Jan 30, 2021·European Journal of Cancer Care·Katrina AndersonJulia E Clark
Mar 25, 2021·PloS One·Alex AregbesolaTerry P Klassen
May 19, 2021·BMJ Quality & Safety·Robert E Burke, Perla J Marang-van de Mheen

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