Introduction The Hospital del Niño Morelense (HNM) is an institution where cancer patients’ care is a priority and survival improvement an important goal. It is known that infectious complications are one of the main causes of death, related to immunosuppression due to disease and treatment. Fever and neutropenia are the main clinical condition for which patients come to the emergency room. Thus, it’s necessary to have standardized care procedures that guide and facilitate antimicrobial therapy administration in the shortest time to reduce morbidity and mortality risk in P-HOPf. Aligned with this goal, HNM joins the Golden Hour (GH), an initiative of Mexico in Alliance with St Jude (MAS). Objective: To implement a quality improvement process that guarantees the administration of the first antibiotic dose to P-HOPf within 60 minutes of admission.

Methodology Improvement cycles (PDSA/PHEA) were implemented to test ideas for change: care flow chart, golden car for supply, removing administrative barriers, training health providers and care parents. Time indicators and satisfaction surveys were used before and after the GH implementation in February 2022. Measurements: Time between Triage and Indication (TTI), Time between Indication and Administration (TIA) and total sum from Triage to Administration (TTA) were measured in minutes. User satisfaction was measured through surveys with a scale from 0 to 100% and an open question. Analysis: The TTI, TIA and TTA indicators were analyzed before and after interventions. A qualitative analysis was carried out for users and health providers satisfaction surveys.

Results A significant reduction was observed in the TTA after the intervention, from a median base line of 189 minutes and average of 180 min to a sustained improvement of 41 minutes as a median and average of 32 min. Achieving the goal of 50% of P-HOPf that received first antibiotic dose at the fourth month of intervention and 80% on December 2023. Better care in emergency department (90%) is perceived by the users after the interventions. Fewer admissions to intensive care and deaths of P-HOPf were recorded.

Conclusions The Golden Hour implementation made possible to reduce care time, which decreased the risk of infectious complications and made it possible to achieve high satisfaction of the user and health providers.