Tata Memorial Centre: Propagating Excellence in Clinical Operations

Evidence based medicine (EBM) requires a level of maturity in the processes, both clinical and non-clinical, which is gained typically over years through consistent deliberate efforts. It is argued that the role of clinical leadership is critical to this. In addition, challenges of implementing EBM are easiest to surmount in single location organizations but complicate considerably when there are multiple distributed locations. While EBM is gaining momentum in health care systems of more developed countries, examples of successful implementation are few in India. Indian institutions face the unique challenge of sorting through multiple bases of foreign evidence (differing guidelines in the UK and U.S.) in addition to domestic evidence covering interventions less frequently used outside of India. The Tata Memorial Centre (TMC) is a pioneer in cancer care and research in India. Over several decades, they have developed an indigenous approach to development and implementation of Evidence based medicine, which has catapulted them into leading cancer hospitals in the world. Set in March 2016, this case study describes TMC's journey thus far with particular emphasis on changes in organizational design as key enablers. TMC's next frontier is to propagate this model of clinical excellence to other cancer hospitals in India through the formation of National Cancer Grid. The key challenge confronting Dr. Rajendra Badwe, Director of TMC, is can these other hospitals accelerate their journey based on the learnings from TMC or whether they will have to customize their approach based on their own operating context. More broadly, which elements of TMC's clinical excellence model are replicable in other hospitals and what organizational changes would be required to implement them.

• Service system design
• Operations strategy