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This was an innovation project supported by the Better Care Victoria Innovation Fund.

Lead organisation

Peter MacCallum Cancer Centre


  • Monash Health
  • Austin Health
  • The Royal Children’s Hospital (RCH)


Febrile neutropenia (FN) is one of the most common complications of cancer treatment and the leading cause of unplanned hospital admissions. 

At most Victorian hospitals, anyone presenting with FN will be admitted and treated with antibiotics intravenously. However, this approach can lead to the overtreatment of up to 50 per cent of patients as children and adults with cancer and FN have varying degrees of risk of severe infection. 

Local and international evidence has shown that people with low-risk FN can safely be managed at home and that this can improve their quality of life.

Building on the success of an earlier trial, the Peter MacCallum Cancer Centre sought to expand home care of adult low-risk FN patients with cancer to three health services, and to adapt the program for children with cancer.


Implement an evidence-based program for the identification and outpatient management of low-risk FN in children and adult patients with cancer across three sites


Over 12 months, the project:

  • transferred 51 low-risk FN patients to home-based care
  • reduced hospital length of stay at two health services
  • saved 178 hospital bed days
  • freed up more specialised cancer beds for children requiring in-hospital chemotherapy at the RCH Children's Cancer Centre
  • saved more than $5,000 in costs per patient treated on the low-risk FN program
  • improved quality of life for patients and carers on the program


December 2020 – The new model of care has been embedded into standard practice at all three sites and the paediatric low-risk FN program is currently being scaled up across Australia. There are eight tertiary paediatric cancer hospitals involved in the scaling project.

The National Centre for Infections in Cancer (NCIC) also hosts the adult and paediatric low-risk FN program toolkits and education packages on its website so other interested health services can access them.

Project summary

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