Standards for Pediatric Cancer Centers

Abstract

Since the American Academy of Pediatrics-published guidelines for pediatric cancer centers in 1986, 1997, and 2004, significant changes in the delivery of health care have prompted a review of the role of medical centers in the care of pediatric patients. The potential effect of these changes on the treatment and survival rates of children with cancer led to this revision. The intent of this statement is to delineate personnel, capabilities, and facilities that are essential to provide state-of-the-art care for children, adolescents, and young adults with cancer. This statement emphasizes the importance of board-certified pediatric hematologists/oncologists and appropriately qualified pediatric medical subspecialists and pediatric surgical specialists overseeing patient care and the need for specialized facilities as essential for the initial management and much of the follow-up for pediatric, adolescent, and young adult patients with cancer. For patients without practical access to a pediatric cancer center, care may be provided locally by a primary care physician or adult oncologist but at the direction of a pediatric oncologist. Pediatrics 2014;134:410-414

Identifying causes of variability in outcomes in children with acute lymphoblastic leukemia treated in a resource‐rich developing country

“…The study from Egypt was conducted at a pediatric hematology/oncology unit in a university hospital setting where supportive care medications were described as challenging, while the present study was conducted in an oncology center with readily available resources [7]. Treatment of childhood ALL involves many potential complications and requires pediatric supportive care facilities that are capable of delivering current international standards of care [15]. Indeed, the availability of supportive care is an important determinant of good therapeutic outcome [13].…”

Access to paediatric oncology centres in Switzerland: Disparities across rural–urban and Swiss‐foreigners cohorts

“…Our analysis yielded several findings that contribute towards facilitating timely access to comprehensive specialised paediatric oncology care in Switzerland. This is crucial, since the benefits of multidisciplinary cancer treatment for quality of care and care outcomes have been well documented (American Academy of Paediatrics, 2014 ).…”

Quality criteria for pediatric oncology centers: A systematic literature review

“…Guidelines on how to approach a child with F&N (availability, risk-stratified approach, escalation for fever persistence) 13,24,25,47 Number/proportion of clinical F&N episodes in which the patients with or without microbial focus are treated with first line antibiotics according to local guidelines 47 Number/proportion of clinical F&N episodes in which patients are admitted to ICU 47 Number/proportion of clinical F&N episodes in which the patient died 47 Number/proportion of fungal health careassociated infections 20 Time to antibiotics (TTA) administration [19][20][21][22] Treatment Number/proportion of patients presented in the interdisciplinary tumor conference (for solid and liquid tumors separately or combined) 9,12,24,48 Protocol compliance (e.g., number of major clinical trial protocol violations) 13,24,39 Number/proportion of clinical trial participation 9,13,14,24,25,29,39 Number/proportion of refusal and failure to complete treatment 13 Delay in/ wait time to start of Radiotherapy 13 Chemotherapy 13,24,25 First therapeutic intervention 24,25 Release of pathology results 13,24,25 Medication Number/proportion of patient safety incidents related to chemotherapy prescriptions 14 Number/proportion of actual drug or dose errors identified for patients on active treatment 13,…”

“…Access to the following important facilities Pharmacy 12,29,48 Microbiology Institute 48 Pediatric cardiology 48 Adult hematology and oncology 48 Laboratories 11,12,29,48 : hematology, hematopathology, clinical chemistry, transfusion Pathology 29,48 Orthopedics 48 Pediatric intensive care unit 29,48 Pediatric radiology 12,29,48 Stem cell transplant unit 12 Pediatric nephrology 12,29,48 Radiation therapy 12,20,29,48 Pediatric surgery 29,48 Pediatric neurosurgery 13,29,48 Nuclear medicine 48 Pediatric anesthetics 29 Hospital hygiene 48 Childhood cancer registry 9,11,29 Multidisciplinary team (MDT) and other experts MDT established, including regularly scheduled MDT conferences 9,[11][12][13]29,48 Number of pediatric oncology disciplines with multidisciplinary staffing ratios for pediatric oncology 13,24,…”

“…The European Society for Paediatric Oncology (SIOPE) provides a guideline document for European pediatric oncology centers on standards of care for children with cancer 11 . Additional guidelines exist for the United States and the United Kingdom 12–14 . In addition, different research groups developed and suggested specific quality criteria.…”