Anoosha Moturu, Sehar Salim Virani, Taylor Jaraczewski, Belay Melesse, Tien Vo, Clifford Y Ko, Francis Pikiti, Hazel Sonkwe, Bright Moyo, Kelly McQueen, Girma Tefera, Xane Peters, Daniel Ojuka, Haytham Kaafarani, Robert Parker, Chris Dodgion, Deborah Rusy, Syed Nabeel Zafar
{"title":"中低收入国家围手术期质量改善的能力建设:来自蒙巴萨、卢萨卡和哈瓦萨的经验。","authors":"Anoosha Moturu, Sehar Salim Virani, Taylor Jaraczewski, Belay Melesse, Tien Vo, Clifford Y Ko, Francis Pikiti, Hazel Sonkwe, Bright Moyo, Kelly McQueen, Girma Tefera, Xane Peters, Daniel Ojuka, Haytham Kaafarani, Robert Parker, Chris Dodgion, Deborah Rusy, Syed Nabeel Zafar","doi":"10.1002/wjs.70126","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Perioperative morbidity and mortality remain disproportionately high in low- and middle-income countries (LMICs). Quality improvement (QI) has shown effectiveness in improving health outcomes and patient safety across healthcare systems globally and is often a mandatory part of training in high income countries. However, QI education in LMICs remains decentralized and limited in scope. Aiming to address this gap, we designed and delivered perioperative QI education in three LMIC settings. This study aims to summarize methodology and experiences across the three settings and outline the factors leading to success and challenges experienced to inform future QI education efforts in LMICs.</p><p><strong>Methods: </strong>We designed and implemented a perioperative QI curriculum that included online didactic content, course assessments, and a two to three day in-person course featuring both didactic and QI project development training. Descriptive statistics were reported for course features and participant pre- and post-course survey results. Qualitative course feedback from participants and administrators is summarized in a narrative format.</p><p><strong>Results: </strong>Five courses were conducted, training a total of 90 participants. Of those who completed pre-course surveys, most participants were nurses (35.5%) or residents (43.6%), and the majority (71.1%) had no prior experience with QI. Self-assessed comfort significantly improved across several domains, including understanding QI concepts, developing aim statements, and designing projects. Qualitatively, participants enjoyed the course's interactive format and recommended future offerings be longer, more frequent, and include expanded content on data analysis and project implementation. Course administrators recommend involving local partners throughout course development, forming structured plans to sustain QI initiatives started as part of the course, and ensuring any pre-course materials use context-specific examples.</p><p><strong>Conclusion: </strong>Implementation of a perioperative QI curriculum across three LMIC settings was feasible and associated with significant improvements in participant-reported comfort with core QI skills and knowledge. Success was driven by the inclusion of local faculty, interactive project development, and adaptation of course content to local context. Future efforts should focus on building local QI mentorship capacity, integrating QI education into residency training, and developing contextually appropriate resources to support scalable, sustainable QI training in LMICs.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.5000,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Building Capacity in Perioperative Quality Improvement in Low- and Middle- Income Countries: Experiences From Mombasa, Lusaka and Hawassa.\",\"authors\":\"Anoosha Moturu, Sehar Salim Virani, Taylor Jaraczewski, Belay Melesse, Tien Vo, Clifford Y Ko, Francis Pikiti, Hazel Sonkwe, Bright Moyo, Kelly McQueen, Girma Tefera, Xane Peters, Daniel Ojuka, Haytham Kaafarani, Robert Parker, Chris Dodgion, Deborah Rusy, Syed Nabeel Zafar\",\"doi\":\"10.1002/wjs.70126\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Perioperative morbidity and mortality remain disproportionately high in low- and middle-income countries (LMICs). Quality improvement (QI) has shown effectiveness in improving health outcomes and patient safety across healthcare systems globally and is often a mandatory part of training in high income countries. However, QI education in LMICs remains decentralized and limited in scope. Aiming to address this gap, we designed and delivered perioperative QI education in three LMIC settings. This study aims to summarize methodology and experiences across the three settings and outline the factors leading to success and challenges experienced to inform future QI education efforts in LMICs.</p><p><strong>Methods: </strong>We designed and implemented a perioperative QI curriculum that included online didactic content, course assessments, and a two to three day in-person course featuring both didactic and QI project development training. Descriptive statistics were reported for course features and participant pre- and post-course survey results. Qualitative course feedback from participants and administrators is summarized in a narrative format.</p><p><strong>Results: </strong>Five courses were conducted, training a total of 90 participants. Of those who completed pre-course surveys, most participants were nurses (35.5%) or residents (43.6%), and the majority (71.1%) had no prior experience with QI. Self-assessed comfort significantly improved across several domains, including understanding QI concepts, developing aim statements, and designing projects. Qualitatively, participants enjoyed the course's interactive format and recommended future offerings be longer, more frequent, and include expanded content on data analysis and project implementation. Course administrators recommend involving local partners throughout course development, forming structured plans to sustain QI initiatives started as part of the course, and ensuring any pre-course materials use context-specific examples.</p><p><strong>Conclusion: </strong>Implementation of a perioperative QI curriculum across three LMIC settings was feasible and associated with significant improvements in participant-reported comfort with core QI skills and knowledge. Success was driven by the inclusion of local faculty, interactive project development, and adaptation of course content to local context. Future efforts should focus on building local QI mentorship capacity, integrating QI education into residency training, and developing contextually appropriate resources to support scalable, sustainable QI training in LMICs.</p>\",\"PeriodicalId\":23926,\"journal\":{\"name\":\"World Journal of Surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-10-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World Journal of Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/wjs.70126\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/wjs.70126","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
Building Capacity in Perioperative Quality Improvement in Low- and Middle- Income Countries: Experiences From Mombasa, Lusaka and Hawassa.
Background: Perioperative morbidity and mortality remain disproportionately high in low- and middle-income countries (LMICs). Quality improvement (QI) has shown effectiveness in improving health outcomes and patient safety across healthcare systems globally and is often a mandatory part of training in high income countries. However, QI education in LMICs remains decentralized and limited in scope. Aiming to address this gap, we designed and delivered perioperative QI education in three LMIC settings. This study aims to summarize methodology and experiences across the three settings and outline the factors leading to success and challenges experienced to inform future QI education efforts in LMICs.
Methods: We designed and implemented a perioperative QI curriculum that included online didactic content, course assessments, and a two to three day in-person course featuring both didactic and QI project development training. Descriptive statistics were reported for course features and participant pre- and post-course survey results. Qualitative course feedback from participants and administrators is summarized in a narrative format.
Results: Five courses were conducted, training a total of 90 participants. Of those who completed pre-course surveys, most participants were nurses (35.5%) or residents (43.6%), and the majority (71.1%) had no prior experience with QI. Self-assessed comfort significantly improved across several domains, including understanding QI concepts, developing aim statements, and designing projects. Qualitatively, participants enjoyed the course's interactive format and recommended future offerings be longer, more frequent, and include expanded content on data analysis and project implementation. Course administrators recommend involving local partners throughout course development, forming structured plans to sustain QI initiatives started as part of the course, and ensuring any pre-course materials use context-specific examples.
Conclusion: Implementation of a perioperative QI curriculum across three LMIC settings was feasible and associated with significant improvements in participant-reported comfort with core QI skills and knowledge. Success was driven by the inclusion of local faculty, interactive project development, and adaptation of course content to local context. Future efforts should focus on building local QI mentorship capacity, integrating QI education into residency training, and developing contextually appropriate resources to support scalable, sustainable QI training in LMICs.
期刊介绍:
World Journal of Surgery is the official publication of the International Society of Surgery/Societe Internationale de Chirurgie (iss-sic.com). Under the editorship of Dr. Julie Ann Sosa, World Journal of Surgery provides an in-depth, international forum for the most authoritative information on major clinical problems in the fields of clinical and experimental surgery, surgical education, and socioeconomic aspects of surgical care. Contributions are reviewed and selected by a group of distinguished surgeons from across the world who make up the Editorial Board.