| Introduction | Aims and Mission | Course Details | The Team |
INTRODUCTION:
The National Cancer Grid (NCG) is committed to achieving its vision of high-quality cancercare, by nurturing the capacity and culture of quality improvement (QI) across cancer care services in India. For the purpose of developing competencies in quality improvement, the NCG now hosts a ‘Quality Improvement Hub (QI Hub) in collaboration with Stanford Medicine - USA, a leader in educational programs for quality improvement for clinical teams. This has been possible through a generous grant from the Tata Trusts.
The QI Hub aims to initiate, inculcate and integrate the culture of Quality through its immersion educational initiative EQuIP-India - Enable Quality Improve Patient Care. This educational program provides the participants with conceptual understanding and an immersion experience necessary to respond to quality related problems across a complex environment such as clinical practice settings. EQuIP India is inspired by the PC-PAICE (Palliative Care-Promoting Assessment & Improvement of Cancer Experience) program of Stanford Medicine and combines a structured curriculum with mentored exercises in designing and implementing quality improvement processes at the host institution.
The VISION & MISSION:
| The Vision | The Mission |
|---|---|
| QI Hub envisions that quality and its continuous improvement are integrated within the care processes of cancer centres across India. | Through its flagship educational program EQuIP-India, QI Hub-India will foster the capacity for Quality Improvement within cancer centres, and facilitate its integration within preventive, diagnostic, therapeutic, and palliative care processes. |
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EQuIP INDIA –LEARNING OBJECTIVES
The participants will learn to:
- Nurture state-of-the-art clinical practice improvement projects;
- Utilise quality improvement methods to evaluate and improve care processes;
- Inspire positive attitude for continuous quality improvement, and
- Foster internal quality improvement capacity.
COURSE DETAILS:
Using the identified problem from the institution, each team is guided through the A3 methodology for improving the quality of their identified problems. This is done through virtual monthly discussions which have didactic sessions on specific QI concepts, followed by discussions on each team’s project. The training is strengthened and facilitated through mentored experiential learning and an in-person QI workshop.
The virtual meetings are held monthly using the Zoom platform, at pre-scheduled dates and times. The in-person workshop is a whole day intensive on quality improvement attended by the Team leaders, and mentors – both Indian and international.
The Quality Improvement Learning Collaborative offers The EQuIP India: Enable Quality Improve Patient Care Course- 2021
HOW TO APPLY:
Clinical teams/ departments interested in applying for EQuIP India training, may fill and submit this Application Form . This is not meant for individual participants.
Last date for submission: The online application is open until Friday, 9th January 2021 10.30pm
For any technical difficulties in filling the application form, please contact Dr. Medha Joshi This email address is being protected from spambots. You need JavaScript enabled to view it.
For questions and clarifications related to the course, please contact Dr Shirley Salins - This email address is being protected from spambots. You need JavaScript enabled to view it. or Dr Nandini Vallath – This email address is being protected from spambots. You need JavaScript enabled to view it.
TENTATIVE COURSE SCHEDULE
The session timings will be 7.00-8.15 AM to suit the time zones of 3 continents.
| Schedule | Topics of Didactic sessions |
Zoom 7.00 -8.15 AM |
|---|---|---|
| February 2021 | Introductions, Why Quality Improvement Science in Healthcare? followed by pairing and ice-breaking session with mentors (break-out rooms) | Pre-session 1 |
| Email, WhatsApp or virtual meetings |
Mentor – Team ice-breaking sessions Scheduled privately as per the convenience of the teams and mentors |
|
| March 2021 | Overview of a completed Project by an alumni - Followed by Q & A | Pre-session 2 |
| Email, WhatsApp or virtual meetings |
Mentor – Team discussions – scoping the problem Scheduled privately as per the convenience of the teams and mentors |
|
| March 2021 |
Understanding System Complexity Bringing a Structure to Problem Solving Using A3 Thinking |
Session 1 |
| Email, WhatsApp or virtual meetings |
Mentor – Team discussions – identifying, charting outcome measures, deciding SMART Goals Scheduled privately as per the convenience of the teams and mentors |
|
| April 2021 | Understanding the Current State of the selected problem | Session 2 |
| Email, WhatsApp or virtual meetings |
Mentor – Team discussions – process mapping, cause-effect diagram Scheduled privately as per the convenience of the teams and mentors |
|
| May 2021 | Identifying the most Impactful Root Causes | Session 3 |
| Email, WhatsApp or virtual meetings |
Mentor – Team discussions – Pareto analysis Scheduled privately as per the convenience of the teams and mentors |
|
| June 2021 | QI Workshop - From analysis of the identified problem to intervening & improving the situation - Key Drivers and interventions | |
| July 2021 | Testing Ideas using Iterative Problem Solving | Session 4 |
| Email, WhatsApp or virtual meetings | Mentor – Team discussions – owners, roles, responsibilities Scheduled privately as per the convenience of the teams and mentors |
|
| August 2021 | QI Project –Management of change, reliability & sustainment | Session 5 |
| Email, WhatsApp or virtual meetings | Mentor – Team discussions – review PDSA Scheduled privately as per the convenience of the teams and mentors |
|
| September 2021 | Using Measures to Drive Improvement | Session 6 |
| Email, WhatsApp or virtual meetings |
Mentor – Team discussions – contextual sustenance plan Scheduled privately as per the convenience of the teams and mentors |
|
| October 2021 |
EQuIP- India Virtual Graduation Ceremony Individual project presentations by Teams with Key outcomes and learnings |
Session 7 |
THE TEAM:
Stanford -India Quality Improvement Leadership Team
| Stanford Quality Improvement Team | Quality Improvement Hub India Team |
|---|---|
| Jake Mickelsen - Administrative Director, Value Improvement, Stanford Health Care (This email address is being protected from spambots. You need JavaScript enabled to view it.) | Nandini Vallath – Director Quality Improvement Hub - India, National Cancer Grid, India |
| Michelle De Natale - Executive Director, Stanford Improvement Capability International Collaborative (ICIC), Executive Director, Strategic Operations, Stanford Health Care (This email address is being protected from spambots. You need JavaScript enabled to view it.) | Sarbani Ghosh Laskar – Co-Executive Director Quality Improvement Hub -India, National Cancer Grid, India |
| Karl Lorenz – Chief -Stanford Palliative Care Section | Vanessa Damania – Executive Officer Quality Improvement Hub -India, National Cancer Grid, India (This email address is being protected from spambots. You need JavaScript enabled to view it.) |
Activities Completed
- 2017-18 PILOT COHORT: The pilot project of PC-PAICE was completed successfully with teams from seven major cancer and palliative care centres across India. The in-person workshop was organised at The All India Institute of Medical Sciences (AIIMS), New Delhi in 2018. Links here - Participants of the 2017-2018 Pilot Cohort.
- 2018-2019 COHORT: The 1 st cohort from QI Hub - India completed the PC-PAICE program and improved processes of identified concerns at cancer and palliative care centres from different parts of India. The in-person workshop was organised at IAPCON 2019 at Cochin, Kerala. Links here - Participants of the 2018-2019 Cohort
- 2019-2020 : The current cohort has expanded to include eight teams; four from oncology and four from palliative care backgrounds. The QI in-person workshop took place 14 th February, 2020 as the Pre-conference workshop IAPCON 2020 in Guwahati, Assam. The Graduation of the current cohort is due in June 2020.
- The IAPCON 2020 featured two Plenary sessions on Quality Improvement by Karl Lorenz, Jake Mickelson and Nandini Vallath. Links here - Participants of the 2019-2020 Cohort.
For More Information
Please contact Ms. Vanessa Damania at : This email address is being protected from spambots. You need JavaScript enabled to view it.
Frequently Asked Questions
Q.What does Quality mean in terms of clinical cancer care?
These are issues in the realms of efficiency of care, effectiveness, safety, quality of care; or outcomes and satisfaction with the care provided.
Q. How is our regular clinical work influenced by doing the EQuIP India Program?
EQuIP India is committed to building the capacity of the participating team, for quality improvement in clinical care. The program provides conceptual understanding and the tools necessary to identify and resolve real-time issues affecting the quality of clinical services chosen by the team for their institution.
The team approaches the selected problem trough the duration of the EQuIP India Program, try interventions in a mentored structured manner and is able to demonstrate a measurable improvement.
Q.What do the team leaders gain as professionals?
The teams will be taken through a complete cycle of improvement through this mentored project. After completion, the participants will have the capacity to guide their teams and conduct improvement projects using the A3 QI methodology, in their own institutions. The project also provides the opportunity to the institutions to be pioneers in developing the field of quality improvement science in the country. 22 teams from across India have completed the training since September 2017.
Q. What happens once we join EQuIP India Program?
The centre interested in building capacity in improving the quality of services, nominates two Team Leaders. The team leaders, in consensus with their department / team, will then select a problem, that is significantly affecting the quality of care of their work. The team works on the problem methodically under QI mentors and provides regular updates on their progress during the virtual QI monthly meetings.
Q. What is the QI training like?
Using the identified problem from the institution, each team is guided as per the A3 methodology to help improve their quality concern. This is done through virtual monthly sessions, which will have didactic sessions on specific concepts of QI and discussions on each team’s project. The training is strengthened and facilitated through mentored experiential learning and the QI workshop.
Q. Is the attendance of teaching sessions compulsory?
The program is action based, with each session empowering the teams on the next move. There is plenty to be gained from other project discussions as well. In the interest of learning and to ensure clarity on QI concepts, the team leaders are expected to attend each and every virtual session. If a session is missed due to unavoidable reasons, the member is expected to go through the recordings of the sessions to stay aligned with the flow of the training levels. 80% minimum attendance is mandatory for virtual sessions. The QI workshop session is mandatory.
Q. How is the QI workshop conducted?
. The workshop will be conducted in the month of May/June, either as in-person session or as live virtual sessions – depending on the pandemic situation. Attendance is compulsory.
Q. Can an individual participate?
No. The QI is a team project. Besides the team leaders, QI processes require team members e.g. doctor, nurse, paramedical personnel, administrative personnel, working together to resolve the identified problem.
Q. Who are the mentors for the programme?
The mentors are a mix of national as well as international faculty (USA, Australia). They will be paired with each team and will be accessible to the team as pre-scheduled, during the course of the QI project.
Q. Is it open only to cancer centres?
The program is open to teams involved with oncology care including palliative care services. The represented institution should be members of the NCG. The membership is free and the institution wishing to participate can become a member by completing the brief formalities by visiting the NCG web-site. https://tmc.gov.in/ncg/index.php/become-a-ncg-member. This may be completed after submitting the application, but prior to 15th of January 2021.
Q. How many teams will be selected?
For the QI Cohort 2021, a total of 8 projects teams from Oncology and Palliative Care background will be selected. The selection process is based on predecided criteria.
Q. Is there a certificate of accomplishment?
Yes. The certificate will be issued by the Stanford – NCG EQuIP-India QI Learning Collaborative. Team leaders will receive a Certificate of Achievement, and the QI project participants from the institution will receive Certificate of Participation.
PARTICIPANTS OF THE 2017-2018 PILOT COHORT
| SR. NO. | NAME OF PARTICIPATING INSTITUTION | TEAM MENTOR & MENTOR INSTITUTION |
|---|---|---|
| 1. | MNJ Institute of Oncology, Telangana | Michael Rabow, MD, FAAHPM – University of California San Francisco (UCSF) |
| 2. | Trivandrum Institute of Palliative Sciences, Trivandrum, Kerala | Stephanie Harman, MD – Stanford Medicine Sridhar Seshadri, PhD – Stanford Medicine |
| 3. | Thrissur Institute of Palliative Care, Kerala | Jane Philips, RN, PhD - University of Technology Sydney Meera Agar, MBBS – University of Technology Sydney |
| 4. | Homi Bhabha Cancer Hospital and Research Centre, Vishakhapatnam | David Casarett, MD – Duke University |
| 5. | All India Institute of Medical Sciences, New Delhi | Karl Lorenz, MD, MSHS – Stanford Medicine, California Michelle De Natale, MSc – Stanford Medicine Jake Mickelsen, MBA – Stanford Medicine |
| 6. | Tata Memorial Centre, Mumbai, Maharashtra | Sydney Dy, MD, MS – Johns Hopkins Medicine |
| 7. | CIPLA Palliative Care Centre | Odette Spruijit, MD – Peter Mac Callum Cancer Centre Karen Anderson, MSocSci (Couns), GradDipArts(Couns), DipBus, BEduc, DipTch – Edith Cowan University, Australia |
PARTICIPANTS OF THE 2018-2019 COHORT
| SR. NO. | NAME OF PARTICIPATING INSTITUTION | TEAM MENTOR & MENTOR INSTITUTION |
|---|---|---|
| 1. | Gujarat Cancer Research Institute, Ahmedabad | Karl Lorenz, MD, MSHS – Stanford Medicine, California Jayita Deodhar, MD Psychiatry – Tata Memorial Hospital, Mumbai |
| 2. | JIPMER, Puducherry | Michelle De Natale, Msc – Stanford Healthcare Vidya Viswanath, MD - Homi Bhabha Cancer Hospital and Research Centre, Andhra Pradesh |
| 3. | Institute of Palliative Medicine, Calicut | Karen Anderson, MSocSci (Couns), GradDipArts(Couns), DipBus, BEduc, DipTch – Edith Cowan University, Australia M. M. Sunil Kumar, MBBS, DPPM,MSc - Trivandrum Institute of Palliative Sciences, Kerala |
| 4. | CanKids KidsCan New Delhi | Meera Agar, MBBS – University of Technology, Sydney Jyothi Jayan Warrier, M.Com – Pain and Palliative Care Society, Thrissur |
| 5. | Cachar Cancer Hospital and Research Centre, Assam | Jake Mickelsen, MBA – Stanford Healthcare, USA Nandini Vallath, MD - QI Hub India, Tata Trusts National Cancer Care Program |
| 6. | Tata Medical Center, Kolkata | Michael Rabow, MD,FAAHPM – University of California San Francisco (UCSF) Gayatri Palat, DNB – MNJ Institute of Oncology, Telangana |
| 7. | Bhagwan Mahaveer Cancer Hospital and Research Centre, Jaipur | Odette Spruijit, MD – Peter Mac Callum Cancer Centre Leela Digumarti, MD - Homi Bhabha Cancer Hospital and Research Centre, Andhra Pradesh |
PARTICIPANTS OF THE 2019-2020 COHORT
| SR. NO. | NAME OF PARTICIPATING INSTITUTION | TEAM MENTOR & MENTOR INSTITUTION |
|---|---|---|
| 1. | Believer’s Church Medical College Hospital, Tiruvalla, Kerala | Jyothi Jayan Warrier – Institute of Palliative Medicine, Kerala Lulu Mathews – Institute of Palliative Medicine, Kerala Meera Agar – University of Technology Sydney, Australia |
| 2. | Adyar Cancer Institute, Chennai, Tamil Nadu | Vidya Vishwanath – Homi Bhabha Cancer Hospital and Research Centre, Vishakhapatnam Karl Lorenz – Stanford Healthcare |
| 3. | Malabar Cancer Centre, Kerala | M. M. Sunilkumar – Trivandrum Institute of Palliative Sciences, Kerala Karen Anderson – Edith Cowan University, Australia |
| 4. | Alpha Palliative Care, Kerala | Spandana Rayala -MNJ Institute of Oncology and Regional Cancer Centre, Hyderabad. I. Terrymize – Institute of Palliative Medicine,Kerala Michael (Mike) Rabow – University of California San Francisco |
| 5. | Homi Bhabha Cancer Hospital and Research Centre, Vishakhapatnam | Leela Digumarti – Homi Bhabha Cancer Hospital and Research Centre, Vishakhapatnam Odette Spruijt – Peter Mac Callum Cancer Centre, Australia |
| 6. | Kasturba Medical College, Manipal, Karnataka | Nandini Vallath – Tata Trusts, Mumbai Sydney Dy – Johns Hopkins University, USA |
| 7. | Amrita Institute of Medical Science and Research Centre, Kochi, Kerala | Gayatri Palat – MNJ Institute of Oncology and Regional Cancer Centre, Hyderabad Ravi Kannan – Cachar Cancer Hospital and Research Centre, Assam Jake Mickelsen – Stanford Healthcare |
| 8. | Tata Memorial Centre, Mumbai | Sarbani Ghosh Laskar – Tata Memorial Centre, Mumbai Jayita Deodhar – Tata Memorial Centre, Mumbai Michelle De Natale – Stanford Healthcare |
