Childhood Cancer

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Implementation Research for Improving Care Processes in Pediatric Oncology for Global HOPE Uganda

University of Texas at Austin
Hannah Lewis
Grant Type: 
POST Program Grants
Year Awarded: 
Type of Childhood Cancer: 
General Pediatric Cancer
Project Description: 

Pediatric oncology care is complex, requiring involvement from pediatric oncologists, surgeons and other disciplines in both in- and outpatient settings over long periods of time. In global settings, such as the Global HOPE (GH) site in Kampala, Uganda, these challenges are magnified by lack of resources and a high burden of disease. The GH center in Uganda sees nearly 400 new cases of pediatric cancer a year despite human resource and logistical support limitations. Patient care flows are not well understood, with implications for the efficiency, quality and consistency of care delivered. Utilizing the tools and approaches of implementation research and quality improvement (QI), this study will identify causes for delay and determine appropriate process improvements, with the potential to improve patient experience and outcomes. 

Project Goal
The objective of this research project is to document and understand the core patient care processes of the GH program in Uganda, leading to recommendations that will improve patient flow. Activities will include: 1) Identifying strengths and weaknesses of current care processes through process mapping, establishing key measures and gathering baseline data for current care processes; 2) identifying and proposing recommendations, and designing and implementing associated Plan, Do, Study, Act (PDSA) cycles QI tools used to document and analyze current processes and identify operational challenges. Process map data will be obtained through structured interviews with care providers, administrators, and patients/families, and through observation. During weeks 1-2, the student will work with the GH team in Houston to learn core QI methods and understand implementation in a high-resource setting. In weeks 3-6, the student will work in Uganda at the GH site to draft process maps, identify challenges and improvements under the mentorship of Dr. Lubega, GH Uganda's Medical Director. The team will orient the student to the setting and assist with research implementation. Time permitting, PDSA cycles will be designed and implemented and findings presented to Dr. Lubega. In weeks 7-8, the student will return to Houston to finalize and present findings to the GH leadership. At project end, the student will have created a repository of process maps for current care processes at the GH site in Uganda, presented a summary of local needs and proposed recommendations to leadership, and documented any PDSA cycles designed and/or implemented.

Mentored by Dr. David Poplack 
Baylor College of Medicine, Houston, TX

Co-funded by: 
Love Your Melon