BACKGROUND: Timely delivery of antibiotics to febrile immunocompromised (F_I) paediatric @entity1 in the @entity341 ( @entity341 ) and outpatient clinic reduces morbidity and mortality. OBJECTIVE: The aim of this quality improvement initiative was to increase the percentage of F_I @entity1 who received antibiotics within goal in the clinic and @entity341 from 25% to 90%. METHODS: 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 @entity341 . 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. RESULTS: The study period was from January 2010 to January 2015. Pre-arrival planning improved our F_I time to antibiotics in the @entity341 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 implemented a rapid response team to improve reliable venous access in the @entity341 , which increased our mean percentage of @entity1 receiving timely antibiotics to its highest rate (95%). CONCLUSIONS: This stepwise approach with pre-arrival planning using the Chronic Care Model, followed by standardisation of processes, created a sustainable improvement of timely antibiotic delivery in F_I @entity1 .

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

@entity1 :: ('9606', 'Species') :: ['patients'] @entity341 :: ('MESH:D004630', 'Disease') :: ['emergency department', 'ED']
@entity1 :: (9606,Species) :: ['children']
