Implementation of Evidence-Based Care in the Sickle Cell and Hemophilia Patient Population

Practice guidelines have been developed for pediatric patients with hematologic disorders, and similar to guidelines for other diseases, adherence is variable. Quality improvement initiatives can move implementation of the guidelines from variable to frequent. For children with sickle cell disease (SCD), quality improvement interventions have significantly improved outcomes related to the effective and timely management of acute vaso-occlusive crises (VOC), reducing the frequency of VOC necessitating hospitalization by administration of hydroxyurea, prevention of stroke, and reducing infections such as influenza. Although there are guidelines for the care and treatment of children with hemophilia, quality improvement initiatives are in the early stages.