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。

IF 2.5 3区 医学 Q2 SURGERY
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}
引用次数: 0

摘要

背景:在低收入和中等收入国家(LMICs),围手术期的发病率和死亡率仍然高得不成比例。质量改进(QI)在改善全球卫生保健系统的健康结果和患者安全方面已显示出有效性,并且通常是高收入国家培训的强制性部分。然而,中低收入国家的智力教育仍然是分散的,范围有限。为了解决这一差距,我们在三个LMIC环境中设计并实施了围手术期QI教育。本研究旨在总结三种情况下的方法和经验,并概述导致成功的因素和面临的挑战,为中低收入国家未来的QI教育工作提供信息。方法:我们设计并实施了围手术期QI课程,包括在线教学内容、课程评估和两到三天的面对面课程,包括教学和QI项目开发培训。描述性统计报告了课程特点和参与者课程前后的调查结果。从参与者和管理者那里得到的定性课程反馈以叙述的形式进行总结。结果:共开展5期课程,培训学员90人。在完成课程前调查的参与者中,大多数是护士(35.5%)或居民(43.6%),大多数(71.1%)之前没有QI经验。自我评估的舒适度在几个领域显著提高,包括理解QI概念、制定目标声明和设计项目。从质量上讲,参与者喜欢课程的互动形式,并建议未来的课程更长、更频繁,并包括有关数据分析和项目实施的扩展内容。课程管理员建议在整个课程开发过程中让当地的合作伙伴参与进来,形成结构化的计划,以维持作为课程一部分开始的QI倡议,并确保任何课前材料都使用特定于环境的示例。结论:在三个LMIC环境中实施围手术期QI课程是可行的,并且与参与者报告的核心QI技能和知识的舒适度显着改善相关。成功是由当地教师的参与、互动项目的开发以及课程内容对当地环境的适应所推动的。未来的工作应侧重于建立当地的QI指导能力,将QI教育纳入住院医师培训,并开发适合具体情况的资源,以支持中低收入国家可扩展的、可持续的QI培训。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
World Journal of Surgery
World Journal of Surgery 医学-外科
CiteScore
5.10
自引率
3.80%
发文量
460
审稿时长
3 months
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.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信