Utilization of an ITP quality improvement pathway improves adherence to management guidelines |
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| Authors: | Emily M Harris Kirsty Hillier Michaela Nolan Patricia Meleedy-Rey Taylah Buissereth Rachael F Grace |
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| Institution: | 1. Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA;2. Department of Pediatrics, Division of Pediatric Hematology-Oncology, Hassenfeld Children's Hospital at NYU Langone Health, NYU Grossman School of Medicine, New York, New York, USA;3. Program for Patient Safety and Quality, Boston Children's Hospital, Boston, Massachusetts, USA;4. Pediatric Hematology/Oncology, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, Massachusetts, USA |
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| Abstract: | Despite availability of epidemiologic studies and national guidelines for the management of newly diagnosed pediatric immune thrombocytopenia (ITP), practice variation exists among and within hematology practices. We previously described the development of an ITP pathway guiding management based on bleeding symptoms. Over an 8-year period, integration of this iterative ITP pathway into management of newly diagnosed ITP increased observation rates in children with no or mild bleeding symptoms and improved consistency of laboratory evaluation and treatment strategies without increasing adverse outcomes. This quality improvement initiative has been sustainable, acceptable to providers, and increased adherence to guidelines. |
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| Keywords: | bleeding guideline immune thrombocytopenia pediatrics treatment |
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