Abstract
Introduction
Quality attributes in health care setting include safety, effectiveness, patient centeredness,
timeliness, efficiency, and equity. Quality of care outcomes depend not only on the
clinical interactions between clinicians and patients but also on the effective alignment
and integration of team efforts, logistics, and care processes. The National Cancer
Grid (NCG), with its mandate to facilitate and promote quality standards in patient
care across India, facilitated quality improvement (QI) training as a key initiative
in order to develop competencies within the clinical teams in QI methodology and to
strengthen the quality of cancer care processes across cancer centers in the country.
Objectives
The aim of the study was to describe the inception and evolution of the NCG-QI-Hub,
its flagship QI training program, EQuIP India (Enabling Quality, Improve Patient Care)
to the present model, to illustrate its journey to self-sufficiency and to share the
outcomes of the completed projects.
Materials and Methods
Following a pilot in 2017, the NCG-QI-Hub, in partnership with Stanford Medicine,
initiated a mentored QI training program using A3 QI methodology and tools to address
quality issues impacting cancer care settings. The trainees used the A3 method of
thinking and experienced the plan-do-study-act (PDSA) cycle while improving the identified
quality problem.
Results
Between 2017 and 2024, 89 QI projects across different domains of cancer care (prevention,
treatment, and palliation to survivorship) have been completed. The EQuIP India training
program has facilitated the creation of 10 institution-based QI training hubs that
conduct in-house QI projects, with 45 national mentors and a growing community of
over 300 professionals with competencies in using the methodological steps to conduct
QI projects. Based on the follow-up survey done in 2022, more than 70% of alumni institutions
continued to be associated with quality improvement project programs. The average
project progress score (PPS) achieved at graduation of trainee teams of ≥4.0/5 was
sustained across the years of conducting the educational program.
Conclusion
EQuIP India immersive QI training program has demonstrated that low-cost, structured
QI training programs, contextualized to the institutional culture, are feasible and
successful in improving the quality of cancer care. The venture has successfully built
national-level QI mentorship capacity formation of institutional QI hubs and has thus
triggered a QI culture across alumni NCG centers.
Keywords quality - quality improvement - methodology - medical oncology - cancer care - education
