Impact of PDSA Quality Improvement Model for Radiotherapy Application in Kenya

Abstract

Cancer, a non-communicable disease, is a growing global health issue and it is the second cause of premature deaths globally with more than half of all cancers occurring in the developing countries. Every year in Kenya over 39,000 people are diagnosed with cancer and of these about 27,000 die as a result of the disease. Majority of cancer patients present at advanced stages of the disease which makes their survival dismal resulting to an unprecedented increase in demand for radiotherapy services. Existing evidence in Kenya as in most developing countries indicate that due to the unacceptable long waiting time to radiation therapy. Most cancer patients do not benefit from treatment and palliative applications of radiotherapy which can improve their survival. Radiobiological principles suggest that a delay in starting radiotherapy may have a negative impact on local tumor control. To cope with this growing demand for radiotherapy, modern improvement models need to be studied and adopted into radiotherapy departments. The PLAN- DO-STUDY- ACT (PDSA), is a model which can be explored and possibilities of improvement done to improve the ever elusive survival of cancer patients in Kenya. The PDSA model showed significant reduction in radiotherapy delays at Kenyatta National Hospital, Cancer Treatment Centre. This study aimed to determine the causes of radiotherapy delays, and to develop and implement improvements for reducing radiotherapy delays in patients’ referred for radiotherapy at the Kenyatta National Hospital Cancer Treatment Centre in Kenya. A retrospective survey was conducted for six months to establish the causes of radiotherapy delays for patients referred for radiotherapy treatment of head and neck, breast and cervix which are the commonest cancers diagnosed in Kenya. The PDSA model for improvement was then implemented and monitored for evidence of improvement from May to December 2013. The results showed a decrease in radiotherapy delays in head and neck, breast and cervix cancers from an average delay time of 18.5 days in May 2013 to 8.6 days by December 2013.