Reducing Treatment Deferral in Head and Neck Cancer Patients: A Quality Improvement Study

Objectives: Head and neck cancer (HNC) is a significant health burden in India, with high rates of treatment deferral leading to poorer outcomes. Treatment deferral, in a resource constraint settings, is a critical issue due to sociocultural, economic and logistical challenges. The study aimed to reduce the treatment deferral rate for HNC patients at Cachar Cancer Hospital and Research Centre (CCHRC) from 40% to 20% over 6 months through a systematic quality improvement initiative. Materials and Methods: The study was conducted under the EQuIP India 2022 program, employing a mixed-methods approach. Baseline data from February to April 2022 were analysed to assess the deferral rate. Root cause analysis (RCA) identified key factors contributing to deferrals, including financial barriers, logistical challenges and psychological factors. Interventions included financial support, patient and family motivation programs, workshops and improved communication strategies. Progress was monitored through weekly tracking and evaluations. Results: The intervention successfully reduced the deferral rate from 40% to 18% within 6 months. Key contributing factors identified through Pareto analysis were financial constraints and family dependency on patient earnings. Addressing these challenges through targeted strategies including financial assistance, caregiver job opportunities, patient motivation workshops and active patient navigation targeted interventions led to increased patient compliance and engagement. Conclusion: This study highlights the importance of targeted, data-driven interventions in reducing treatment deferrals. The findings underscore the need for systemic changes, including improved financial support mechanisms and awareness programs, to ensure timely cancer treatment in resource-constrained settings.