Uganda Cancer Institute, Kampala, Uganda.
Am Soc Clin Oncol Educ Book. 2024 Jun;44(3):e432104. doi: 10.1200/EDBK_432104.
Cancer care in low- and middle-income countries (LMICs) faces numerous challenges, such as limited resources, infrastructure constraints, and a shortage of specialized training. To address these challenges, innovative quality improvement (QI) approaches are required. The Quality Oncology Practice Initiative (QOPI) by the ASCO provides a framework for improving care quality through evidence-based standards. This article explores how QOPI has been adapted to the local context of the Uganda Cancer Institute (UCI) and highlights the importance of aligning international best practices with local health care realities to bridge disparities in care standards. The adaptation of the QOPI program at UCI commenced with a collaborative meeting with the ASCO-QOPI team in 2020. A tailored implementation plan was developed focusing on incorporating ASCO's QOPI measures and additional metrics relevant to the Ugandan context, engaging multidisciplinary teams, and optimizing resource use by leveraging existing resources for data collection and analysis. The execution of the plan relied heavily on staff training, participatory data collection, and continuous quality improvement processes that utilized data-driven methodologies. A retrospective analysis of QOPI data of UCI from 2020 to 2023 shows significant improvements in oncology care quality, highlighted by an upward trend in QOPI assessment scores across various metrics. These reflect the journey of UCI toward aligning its oncology care practices with international standards despite facing significant challenges. UCI's experience demonstrated the feasibility and impact of implementing international QI programs in LMICs. The success demonstrates that significant improvements in cancer care quality can be achieved in resource-constrained settings through adaptability, stakeholder engagement, and strategic resource optimization. UCI's journey is a model for other LMICs seeking to raise their cancer care standards, demonstrating that QI is necessary and attainable worldwide.
在中低收入国家（LMICs），癌症护理面临着许多挑战，如资源有限、基础设施受限以及缺乏专业培训等。为了解决这些挑战，需要采用创新性的质量改进（QI）方法。ASCO 的肿瘤质量实践倡议（QOPI）为通过基于证据的标准来提高护理质量提供了一个框架。本文探讨了 QOPI 如何适应乌干达癌症研究所（UCI）的当地情况，并强调了将国际最佳实践与当地医疗保健现实相协调以弥合护理标准差距的重要性。UCI 对 QOPI 计划的适应始于 2020 年与 ASCO-QOPI 团队的合作会议。制定了一项定制的实施计划，重点是纳入 ASCO 的 QOPI 措施和与乌干达国情相关的其他指标，让多学科团队参与，并通过利用现有资源进行数据收集和分析来优化资源利用。该计划的执行严重依赖于员工培训、参与式数据收集以及利用数据驱动方法的持续质量改进过程。对 2020 年至 2023 年 UCI 的 QOPI 数据进行的回顾性分析显示，肿瘤学护理质量有了显著提高，各种指标的 QOPI 评估得分呈上升趋势。这反映了 UCI 尽管面临重大挑战，但仍在努力使肿瘤学护理实践与国际标准保持一致。UCI 的经验证明了在 LMICs 实施国际 QI 计划的可行性和影响。这一成功表明，通过适应性、利益相关者参与和战略资源优化，可以在资源有限的环境中实现癌症护理质量的显著提高。UCI 的历程为其他寻求提高癌症护理标准的 LMICs 提供了一个模型，证明了 QI 在全球范围内是必要且可行的。
