Enhancing the outcome of quality improvement education of the National Cancer Grid, India - An A3 methodological study

Background: Quality being an innate mandate when providing healthcare, competency in quality improvement (QI) has become an important core skill for clinicians to resolve inadequacies within clinical settings. The National Cancer Grid-India (NCG) launched the QI training initiative in collaboration with Stanford Medicine, USA, after a successful pilot in 2017. The nonuniform progress of QI projects during the 2018 cohort left the NCG-QI-Hub dissatisfied. Objectives: The primary objective of this study was to enhance the outcome of Quality Improvement Education of the NCG-India. The secondary objective was to ensure confidence in applying A3 methodological thinking among the cohort team leaders and national mentors after completion of their training. Materials and Methods: This study was conducted online by the newly established multicentric virtual National Cancer Grid Quality Initiative-Hub India (NCG-QI-Hub) between August 2019 and July 2020. A3 methodology for QI was used to analyze the QI problem, which was stated as “The NCG-QI-Hub is dissatisfied with the variability of outcomes of their QI training program.” The SMART goal was to improve the overall satisfaction score of the NCG-QI-Hub-team, recorded monthly after each training session, from 6.6/10 at baseline (graduation of the 2018 cohort) to ≥ 8.5/10 at graduation of the 2019 cohort. Results: The average satisfaction score of the NCG-QI-Hub team at the graduation of the 2019 cohort was 8.7/10. The Project Progress Score (PPS) amongst 2019 graduating teams was between 4.0/5.0 and 4.5/5.0 (Standard deviation(SD) 0.2421). The average confidence level of the 2019 cohort was 4.48/5.0, while that of QI-India mentors was 4.27/5.0 when measured at graduation. The QI project achieved and exceeded the set target of 8.5/10, increasing the satisfaction score of the NCG-QI-Hub-team. Conclusion: Good practice interventions derived through an A3-methodological study of the NCG-QI-Hub training processes significantly improved its training outcomes