Quality Improvement Project Interventions & Team Composition (Bolded items included by all 3 centers)
| Center 1 | Center 2 | Center 3 | |
|---|---|---|---|
| Education Interventions | |||
| 1. Patient/Family information for ED experience during fever with neutropenia (FN) episodes | X | X | X |
| 2. Staff/faculty on consensus guidelines for FN care (Time to Antibiotic goal<60 minutes and Antibiotic type) | X | X | X |
| 3. Staff/faculty initial education & update on project progress | X | X | X |
| 4. Standardized RN central line education/training | X | X | |
| Process Change | |||
| 5. Topical anesthetic to central line site in triage | X | X | X |
| 6. Rapid rooming for all cancer patients with fever | X | X | X |
| 7. Ill appearing or severe triage category placed in resuscitation room | X | X | X |
| 8. Central line equipment more accessible | X | X | X |
| 9. Antibiotic delivery prior to absolute neutrophil count (ANC) result | X | X | X |
| 10. Rapid ANC testing | X* | ||
| 11. Electronic order entry modifications/order set development | X | X | |
| 12. Pharmacy assistance for antibiotic readiness/availability | X | X | |
| 13. MD notified upon patient arrival | X | X | |
| 14.Direct phone communication (Oncology MD to Emergency MD) of incoming patient prior to arrival (when possible) | X | ||
| 15. All febrile cancer patients triage level 1(highest acuity) | X | ||
| TEAM Composition | |||
| Emergency Physicians | X | X | X |
| Emergency Nurses | X | X | X |
| Pharmacy Representative | X | X | X |
| Oncology Physicians | X | X | X |
| Computer Order Entry Representative | X | X | |
| Infectious Disease Physician | X | X | |
| Quality Improvement Representative | X | X |
* At site 2, this rapid ANC testing was trialed but determined to be a failed strategy and was stopped.