INTRODUCTIONFebrile neutropenia (FN) is a severe and potentially life-threatening side effect of chemotherapy. Measuring care provided to children with cancer suffering from FN, would be very valuable in identifying ways to improve care. This measurement can be done with indicators.OBJECTIVESWe aimed to 1) develop three types of indicators (structure, process, outcome) derived from existing evidence-based FN guidelines, and 2) do a pilot implementation of the developed indicators.METHODSFor a detailed flow diagram of the developmental process, see figure 1. The developed indicators were tested in 3 hospitals (1 university hospital, 2 shared care hospitals) in the North of the Netherlands, using retrospectively collected individual patient data. We included all children diagnosed with cancer between 01-01-2014 and 31-12-2015.RESULTS7 indicators were developed, see table 1. In the pilot, 119 FN episodes in 59 patients were included. Notable findings were 1) 100% of episodes without focus (n=108) were treated with guideline-consistent antibiotics (antipseudomonal beta-lactam), 2) in 12.5% of episodes with persistent fever (n=14) guideline-consistent additional testing (aspergillus diagnostics) was performed too late (no registered reason), 3) of all FN episodes (n=119), 18.5% resulted in ICU admittance and 1.7% resulted in death. CONCLUSIONTo our knowledge this is the first project in which indicators for supportive care in childhood cancer were developed. The developed indicators have shown to be competent, as provided care was effectively evaluated. The indicator set will be implemented throughout the Netherlands to evaluate care for children with cancer suffering from FN, and to potentially identify ways to improve care.