Managing Children with Sickle Cell Disease and Fever at Home

Improve Outcomes
Keep Kids out of the Hospital
Reduce Disparities in Care

Why is this important?

Patients with sickle cell disease have an increased risk for blood stream infections, so presumptive treatment with antibiotics and hospital admission was routinely done to avoid complications. However, recent advances such as vaccinations and penicillin prophylaxis have resulted in a decline in the number of serious bacterial infections. Frequent hospitalizations of children with sickle cell disease and fever are stressful for the family and result in a measurable decrease in the quality of life.

What we did

Experts from the Emergency Department (ED) and Hematology at Children's Hospital of Philadelphia (CHOP) created a new clinical pathway to guide the care of these patients with sickle cell disease. The pathway identifies a low-risk group who could safely receive long-acting antibiotics in the ED and then be discharged home while awaiting blood cultures results.

Results

Percent of Children with Sickle Cell Disease and Fever Discharged Home

The discharge rate increased from 0 percent to over 36 percent, an improvement that has been sustained. All patients were safely discharged home.

Updated July, 2019