PROACTIVE

What is PROACTIVE?

The Pediatric Oncology Capacity Assessment Tool for Intensive Care, or PROACTIVE, is a consensus-derived electronic tool that allows health care centers managing critically ill pediatric hematology/oncology (PHO) patients to measure the capacity and quality of their pediatric onco-critical care (POCC) services.

Why is PROACTIVE needed?

Nearly 90% of children with cancer live in low- and middle-income countries that face challenges delivering high-quality pediatric onco-critical care. PROACTIVE aims to help centers in resource-limited settings improve capacity and quality of POCC services over time by identifying gaps in care delivery. With this knowledge, centers can develop quality improvement initiatives aimed at strengthening their POCC services.

PROACTIVE:

• Provides a complete picture of a center’s baseline POCC capacity
• Identifies and helps centers prioritize areas in need of interventions
• Offers an approach to strengthen POCC services for critically ill PHO patients
• Tracks an institution’s performance and progress over time
• Provides a benchmark for institutions at the local and regional level

Data collected also aids in the development of cost-effective interventions to improve outcomes for children with cancer globally.

Who can use PROACTIVE?

PROACTIVE is designed for use in health care centers in resource-limited settings where pediatric intensivists and/or hemato-oncologists manage critically ill PHO patients. To date, 74 centers from 34 countries have completed PROACTIVE.

How does PROACTIVE work?

PROACTIVE uses two surveys that include a total of 200 questions. These surveys are completed by at least two primary providers – one intensivist and one oncologist. Other team members (e.g., nurses, data managers) may provide support and insight to help complete the surveys. The surveys evaluate POCC services across 8 domains:

• National context
• Facility and local context
• Personnel
• Service capacity
• Service integration
• Support services
• Medication and equipment
• Outcomes

PROACTIVE is delivered online using REDCap (Research Electronic Data Capture), hosted at St. Jude Children’s Research Hospital. Answers are scored from 0 to 5, where 5 means strong performance and/or 100% availability of an item and 0 means poor performance and/or absence of an item. The tool is available in English and Spanish.

When is PROACTIVE offered?

PROACTIVE takes place annually from January to May. It includes a 15-week assessment followed by a one-week workshop to teach basic quality improvement (QI) methodology. PROACTIVE launched in English in 2021 and in Spanish in 2023.

For More Information

To learn more or to find out how to implement PROACTIVE at your center, email PROACTIVE@stjude.org.

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