Awareness about Cervical Cancer and Acceptance of Pap Smear for Screening among Women Attending a Tertiary Care Center
Our main objective was to increase the number of pap smears taken amongst women in the age group of 25-60 years (excluding antenatal women) attending the gynecology out-patient department of our hospital. To achieve our outcome goal, process goals were established. The process goals were to improve awareness on cervical cancer prevention and vaccination in both healthcare workers and patients/family attending the gynecology clinic. This study was done using the A3 methodology for quality improvement through the EQuIP India (Enable Quality Improve patient care) program which came about as a collaboration with PC-PAICE (Palliative Care-Promoting Assessment & Improvement of Cancer Experience) program of Stanford. The A3 quality improvement (QI) tool has well defined steps to identify the root cause of any given problem and to derive interventions to solve the stated problem. The steps are as follows(i) Process mapping and Gemba walk for analyzing contributors to the stated problem (ii) Pareto chart- to derive key drivers (iii) Run chart- to measure impact of interventions and sustainability. The progress was monitored biweekly and recorded as run charts for the study period of 9 months. There was an increase in uptake of pap smear rate from 30% to 70% among women in the general gynecology clinic during the study period of 9 months. The application of A3 methodology was very valuable to identify contributors towards a low pap smear rate and to develop interventions to improve cervical cancer awareness and pap smear rates in our hospital..