Harmonization of Infection Care Pathways in Pediatric Oncology

Strategic Insights -

A new study from the Hospital for Sick Children in Toronto, Canada, has highlighted the importance of harmonization in infection care pathways for pediatric oncology patients. Researchers created institution-specific care pathways for managing infection complications in pediatric oncology at four cancer institutions in Ontario, Canada. The study aimed to standardize care delivery approaches across institutions and identify discrepancies between pathways. The findings suggest that harmonization of care pathways can lead to better patient outcomes, but certain elements may not be amenable to harmonization due to institutional differences.

Key Takeaways:

  • Institution-specific care pathways for managing infection complications in pediatric oncology were created at four pediatric cancer institutions in Ontario, Canada.
  • A project was undertaken to harmonize the institution-specific care pathways across institutions.
  • Discrepancies between the pathways were identified, and 33 care pathway components covering 10 clinical actions were prioritized for harmonization.
  • An in-person harmonization meeting was convened, followed by a virtual meeting to finalize the harmonization plan.
  • Harmonization was achieved for 25 of the 33 care pathway components.
  • Eight of the 10 components related to antibacterial and antifungal prophylaxis choice, timing, and indications were harmonized, as were 11 of 16 components related to the initial and ongoing management of febrile neutropenia.
  • Certain care pathway elements may not be amenable to harmonization due to differences in institutional resources, cultures, and priorities.
  • The study concluded that harmonization of infection care pathways across institutions is crucial for improving patient outcomes.
  • Pediatric Oncology Group of Ontario provided financial support for the research.
  • Authors of the study include Ida Mehrdadi, Adam P. Yan, Jennifer Seelisch, Paula D. Robinson, Angela Punnett, Priya Patel, Catherine Mark, Alicia Koo, Donna L. Johnston, Paul Gibson, Stephanie Cox, Sarah Alexander, Michaila Aitcheson, Deborah Tomlinson, L. Lee Dupuis, and Lillian Sung.
  • The study was peer-reviewed and published in Pediatric Blood & Cancer in 2025.

Statistics:

  • 25 care pathway components were harmonized out of 33.
  • 8 of 10 components related to antibacterial and antifungal prophylaxis choice, timing, and indications were harmonized.
  • 11 of 16 components related to the initial and ongoing management of febrile neutropenia were harmonized.
  • 6 of 7 components related to prolonged fever were harmonized.
  • 2025: The year the study was published.

Sources:

  • NewsRx. Hospital for Sick Children Reports Findings in Pediatric Oncology (Multi-Institution Harmonization of Infection Care Pathways for Pediatric Oncology). Pediatrics Week. June 14, 2025; p 341.
  • Multi-Institution Harmonization of Infection Care Pathways for Pediatric Oncology. Pediatric Blood & Cancer, 2025.