EsSalud - Social Health Insurance Institute

Reducing the time taken to start antimicrobial therapy in paediatric onco-haematological patients with febrile neutropenia in the Paediatric Emergency Department

Implementation year

The good clinical practice implemented at the Edgardo Rebagliati Martins National Hospital (Hospital Nacional Edgardo Rebagliati Martins – HNERM), part of Peru’s EsSalud - Social Health Insurance Institute (EsSalud - Seguro Social de Salud), looked to prevent complications of infections in paediatric patients with onco-haematological diseases and febrile neutropenia.

To achieve this, we implemented an innovative care model, training health professionals in the Paediatric Emergency Department to identify patients with febrile neutropenia and start antimicrobial treatment early. The practice is called “decreasing time to therapy” (DOTT) and looks to improve the traditional care process for febrile paediatric oncology patients. Implementing the DOTT model led to a decrease in the time taken to start antibiotic therapy, dropping from 14 hours to less than two hours. It also had positive economic impacts by reducing the length of hospital stays and therefore the use of medical supplies.

Finally, this care model has been recognized internationally by the World Health Organization (WHO) and is cited as an example project in the framework of the Global Initiative for Childhood Cancer.

Service quality