Addressing priorities for surgical research in Africa: implementation of a multicentre cloud‐based peri‐operative registry in Ethiopia

Network for Perioperative Critical care (N4PCc)

doi:10.1111/anae.15394

Addressing priorities for surgical research in Africa: implementation of a multicentre cloud‐based peri‐operative registry in Ethiopia

Network for Perioperative Critical care (N4PCc)

Medical Education

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Abstract

In resource‐constrained settings, where inequalities in access to and quality of surgical care results in excess mortality, peri‐operative care registries are uncommon. A south‐south collaboration supported the implementation of a context specific, clinician‐led, multicentre real‐time peri‐operative registry in Ethiopia. Peri‐operative information, including the Ethiopian Ministry of Health’s national ‘Saving Lives through Safe Surgery initiative’, was linked to real‐time dashboards, providing clinicians and administrators with information on service utilisation, surgical access, national surgical key performance indicators and measures of quality of care. We recruited four hospitals representing 285 in‐patient beds from the Amhara and Southern Nations Nationalities and Peoples regions and Addis Ababa city, and reported on 1748 consecutive surgical cases from April 2019 to April 2020. Key performance indicators included: compliance with the World Health Organization’s Surgical Safety Checklist in 1595 (92.1%) surgical cases; adverse events during anaesthesia in 33 (3.1%) cases; and surgical site infections in 21 (2.0%) patients. This collaboration has successfully implemented a multicentre digital surgical registry that can enable measurement of key performance indicators for surgery and evaluation of peri‐operative outcomes. The peri‐operative registry is currently being rolled out across the Amhara region and Addis Ababa city administration. It will provide continuous granular healthcare information necessary to empower clinicians to drive context‐specific priorities for service improvement and research, in collaboration with national stakeholders and international research consortiums.

Original language	English
Pages (from-to)	933-939
Number of pages	7
Journal	Anaesthesia
Volume	76
Issue number	7
Early online date	25 Jan 2021
DOIs	https://doi.org/10.1111/anae.15394
Publication status	Published - Jul 2021

Bibliographical note

Acknowledgements
The Network for Perioperative and Critical care (N4PCc) authorship includes co‐ordinators and collaborators for the Ethiopian registry. AB is Chair and First Trustee of the Network for Improving Critical Care Systems and Training (UK Charity) and a volunteer with NICS‐MORU. RH is First Trustee of the Network for Improving Critical Care Systems and Training (UK Charity) and a Director (honorary) at NICS‐MORU. NICS‐MORU is a not‐for‐profit organisation based in Sri Lanka, which supported this pilot project and from which the registry originated. The pilot project has been supported by NICS‐MORU, which also partially supported FK’s fellowship period in Sri Lanka, key to the knowledge exchange and establishment of a community of practice. The project’s implementation and scale up is championed by DBU and FMOH.

Keywords

anaesthesia
clinical registries
postoperative morbidity
quality of care
surgery

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10.1111/anae.15394Licence: CC BY-NC-ND

N4PCc_Anaesthesia_Addressing_Priorities_For_VoR
© 2021 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. https://creativecommons.org/licenses/by-nc-nd/4.0/
Final published version, 444 KBLicence: CC BY-NC-ND

Cite this

@article{dea38af39f1347e5b9c510b59a9b6979,

title = "Addressing priorities for surgical research in Africa: implementation of a multicentre cloud‐based peri‐operative registry in Ethiopia",

abstract = "In resource‐constrained settings, where inequalities in access to and quality of surgical care results in excess mortality, peri‐operative care registries are uncommon. A south‐south collaboration supported the implementation of a context specific, clinician‐led, multicentre real‐time peri‐operative registry in Ethiopia. Peri‐operative information, including the Ethiopian Ministry of Health{\textquoteright}s national {\textquoteleft}Saving Lives through Safe Surgery initiative{\textquoteright}, was linked to real‐time dashboards, providing clinicians and administrators with information on service utilisation, surgical access, national surgical key performance indicators and measures of quality of care. We recruited four hospitals representing 285 in‐patient beds from the Amhara and Southern Nations Nationalities and Peoples regions and Addis Ababa city, and reported on 1748 consecutive surgical cases from April 2019 to April 2020. Key performance indicators included: compliance with the World Health Organization{\textquoteright}s Surgical Safety Checklist in 1595 (92.1%) surgical cases; adverse events during anaesthesia in 33 (3.1%) cases; and surgical site infections in 21 (2.0%) patients. This collaboration has successfully implemented a multicentre digital surgical registry that can enable measurement of key performance indicators for surgery and evaluation of peri‐operative outcomes. The peri‐operative registry is currently being rolled out across the Amhara region and Addis Ababa city administration. It will provide continuous granular healthcare information necessary to empower clinicians to drive context‐specific priorities for service improvement and research, in collaboration with national stakeholders and international research consortiums.",

keywords = "anaesthesia, clinical registries, postoperative morbidity, quality of care, surgery",

author = "{Network for Perioperative Critical care (N4PCc)} and Fitsum Kifle and Abi Beane and Dilanthi Priyadarshani and Kokeb Desta and Bezaye Zemedkun and Ermiyas Belay and Jolene Moore and Rashan Haniffa",

note = "Acknowledgements The Network for Perioperative and Critical care (N4PCc) authorship includes co‐ordinators and collaborators for the Ethiopian registry. AB is Chair and First Trustee of the Network for Improving Critical Care Systems and Training (UK Charity) and a volunteer with NICS‐MORU. RH is First Trustee of the Network for Improving Critical Care Systems and Training (UK Charity) and a Director (honorary) at NICS‐MORU. NICS‐MORU is a not‐for‐profit organisation based in Sri Lanka, which supported this pilot project and from which the registry originated. The pilot project has been supported by NICS‐MORU, which also partially supported FK{\textquoteright}s fellowship period in Sri Lanka, key to the knowledge exchange and establishment of a community of practice. The project{\textquoteright}s implementation and scale up is championed by DBU and FMOH.",

year = "2021",

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language = "English",

volume = "76",

pages = "933--939",

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publisher = "Wiley-Blackwell",

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T1 - Addressing priorities for surgical research in Africa

T2 - implementation of a multicentre cloud‐based peri‐operative registry in Ethiopia

AU - Network for Perioperative Critical care (N4PCc)

AU - Kifle, Fitsum

AU - Beane, Abi

AU - Priyadarshani, Dilanthi

AU - Desta, Kokeb

AU - Zemedkun, Bezaye

AU - Belay, Ermiyas

AU - Moore, Jolene

AU - Haniffa, Rashan

N1 - Acknowledgements The Network for Perioperative and Critical care (N4PCc) authorship includes co‐ordinators and collaborators for the Ethiopian registry. AB is Chair and First Trustee of the Network for Improving Critical Care Systems and Training (UK Charity) and a volunteer with NICS‐MORU. RH is First Trustee of the Network for Improving Critical Care Systems and Training (UK Charity) and a Director (honorary) at NICS‐MORU. NICS‐MORU is a not‐for‐profit organisation based in Sri Lanka, which supported this pilot project and from which the registry originated. The pilot project has been supported by NICS‐MORU, which also partially supported FK’s fellowship period in Sri Lanka, key to the knowledge exchange and establishment of a community of practice. The project’s implementation and scale up is championed by DBU and FMOH.

PY - 2021/7

Y1 - 2021/7

N2 - In resource‐constrained settings, where inequalities in access to and quality of surgical care results in excess mortality, peri‐operative care registries are uncommon. A south‐south collaboration supported the implementation of a context specific, clinician‐led, multicentre real‐time peri‐operative registry in Ethiopia. Peri‐operative information, including the Ethiopian Ministry of Health’s national ‘Saving Lives through Safe Surgery initiative’, was linked to real‐time dashboards, providing clinicians and administrators with information on service utilisation, surgical access, national surgical key performance indicators and measures of quality of care. We recruited four hospitals representing 285 in‐patient beds from the Amhara and Southern Nations Nationalities and Peoples regions and Addis Ababa city, and reported on 1748 consecutive surgical cases from April 2019 to April 2020. Key performance indicators included: compliance with the World Health Organization’s Surgical Safety Checklist in 1595 (92.1%) surgical cases; adverse events during anaesthesia in 33 (3.1%) cases; and surgical site infections in 21 (2.0%) patients. This collaboration has successfully implemented a multicentre digital surgical registry that can enable measurement of key performance indicators for surgery and evaluation of peri‐operative outcomes. The peri‐operative registry is currently being rolled out across the Amhara region and Addis Ababa city administration. It will provide continuous granular healthcare information necessary to empower clinicians to drive context‐specific priorities for service improvement and research, in collaboration with national stakeholders and international research consortiums.

AB - In resource‐constrained settings, where inequalities in access to and quality of surgical care results in excess mortality, peri‐operative care registries are uncommon. A south‐south collaboration supported the implementation of a context specific, clinician‐led, multicentre real‐time peri‐operative registry in Ethiopia. Peri‐operative information, including the Ethiopian Ministry of Health’s national ‘Saving Lives through Safe Surgery initiative’, was linked to real‐time dashboards, providing clinicians and administrators with information on service utilisation, surgical access, national surgical key performance indicators and measures of quality of care. We recruited four hospitals representing 285 in‐patient beds from the Amhara and Southern Nations Nationalities and Peoples regions and Addis Ababa city, and reported on 1748 consecutive surgical cases from April 2019 to April 2020. Key performance indicators included: compliance with the World Health Organization’s Surgical Safety Checklist in 1595 (92.1%) surgical cases; adverse events during anaesthesia in 33 (3.1%) cases; and surgical site infections in 21 (2.0%) patients. This collaboration has successfully implemented a multicentre digital surgical registry that can enable measurement of key performance indicators for surgery and evaluation of peri‐operative outcomes. The peri‐operative registry is currently being rolled out across the Amhara region and Addis Ababa city administration. It will provide continuous granular healthcare information necessary to empower clinicians to drive context‐specific priorities for service improvement and research, in collaboration with national stakeholders and international research consortiums.

KW - anaesthesia

KW - clinical registries

KW - postoperative morbidity

KW - quality of care

KW - surgery

U2 - 10.1111/anae.15394

DO - 10.1111/anae.15394

M3 - Article

C2 - 33492690

SN - 0003-2409

VL - 76

SP - 933

EP - 939

JO - Anaesthesia

JF - Anaesthesia

IS - 7

ER -

Addressing priorities for surgical research in Africa: implementation of a multicentre cloud‐based peri‐operative registry in Ethiopia

Abstract

Bibliographical note

Keywords

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