Febrile Neutropenia: Improving Care Through an Oncology Acute Care Clinic

Background: Patients with cancer are at risk for oncologic emergencies, including febrile neutropenia (FN). Timely treatment of FN can prevent complications. Providing this care in the outpatient setting has been shown to be safe and effective.

Objectives: This project implemented and evaluated a new process using an outpatient acute care clinic (ACC) to manage FN in patients with hematologic cancer. The aims were to reduce the time from fever identification to antibiotic administration, decrease emergency department (ED) visit rates, and evaluate patient satisfaction.

Methods: Using a pre-/postimplementation design, an interprofessional team was educated about a new process of caring for patients with hematologic cancer and FN at an outpatient ACC using a comprehensive algorithm.

Findings: 31 patients participated in the project (15 pre- and 16 postimplementation). Time to antibiotic administration decreased from 144.88 minutes to 63.69 minutes. Participant visits to the ED decreased by 2.33 times per month on average. Overall, patients were satisfied with the ACC. These findings support using a dedicated outpatient ACC for patients with FN receiving hematology care.