Using process mapping to improve clinical care for patients receiving cancer treatment in resource-limited settings.

e23249 Background: Process mapping is a low-cost, low-technology approach that can be used to understand and improve clinical processes. It is particularly useful for improving clinical care for patients receiving cancer treatment in resource-limited settings. Neutropenic fever is associated with particularly high rates of mortality, particularly for people receiving cancer treatment in sub-Saharan Africa. In this study, we used process mapping to identify barriers to antibiotic delivery and understand ways in which to improve the antibiotic delivery process at the Uganda Cancer Institute (UCI) in Kampala, Uganda. Methods: In our study, we used a five-phase process mapping framework to build a multidisciplinary process mapping team, develop an antibiotic delivery process map, identify barriers to antibiotic delivery, and begin the process by which to prioritize the barriers to care that should be addressed using implementation strategies. Throughout this framework, we used focus discussion groups as the basis for data collection and analyzed the process map using low-cost supplies and open-access software. Results: From March 2023 – May 2024, we conducted a series of 13 focus discussion groups to develop the process map and 13 additional focus groups to identify barriers to antibiotic delivery in a resource-limited setting. Frequently identified barriers included challenges with communication between team members, limited access to appropriate antibiotics, and the need for patient family members to travel to outside pharmacies to procure medications. Conclusions: Process mapping is a simple, low-cost way to understand the healthcare delivery system and identify areas in which it can be improved. In our study, we were able to use process mapping to understand the antibiotic delivery system for a cancer center in Uganda. The process mapping framework can also be used to understand and improve other cancer delivery processes for patients receiving treatment in resource-limited settings.