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Applying Quality Oncology Practices in Africa: Lean Implementation, Real Impact
Naghib Bogere1, David Mwiine1, Judith Asasira1
1Uganda Cancer Institute, Kampala, Uganda.
Summary
Implementing the American Society of Clinical Oncology
Area of Science:
- Oncology quality improvement in resource-limited settings (RLS).
Background:
- Expanding cancer services in low- and middle-income countries is a priority, but patient outcomes depend on care organization and coordination.
- Structured quality measurement is feasible in RLS, but sustainability without burdening clinical teams is a challenge.
Purpose of the Study:
- To describe the implementation of the ASCO Quality Oncology Practice Initiative (QOPI) Resource-Limited Setting (RLS) track.
- To demonstrate how a lean, stepwise approach can drive sustained improvements in resource-constrained African oncology settings.
Main Methods:
- Applied a lean methodology focusing on process simplification and staged implementation of QOPI RLS.
- Integrated QOPI RLS into routine care using a three-tier structure to stabilize core processes before expanding.
- Analyzed operational examples of QOPI evolving into an embedded governance tool.
Main Results:
- Staged, lean-informed implementation transformed QOPI into an organizing system for care delivery.
- Initial focus on essential processes (documentation, treatment planning) created a baseline; subsequent expansion revealed gaps in safety and coordination.
- Quality activities became embedded, improving systemic therapy delivery, institutional capability, and readiness for complex functions like clinical trials.
Conclusions:
- Structured, stepwise quality approaches enhance oncology care in RLS by improving core process reliability.
- This provides a practical method for applying global standards and improving daily cancer care in diverse health systems.
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