Improving surgical safety checklist utilisation at 23 public health facilities in Ethiopia: a collaborative quality improvement project

BackgroundIn 2009, the WHO introduced the surgical safety checklist (SSC) as one of the interventions for improving patient safety. The systematic use of structured checklists during surgery has been shown to reduce perioperative morbidity and mortality. However, SSC utilisation has been challenging...

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Bibliographic Details
Published in:BMJ open quality 2023-11, Vol.12 (4), p.e002406
Main Authors: Bete, Dawit Yifru, Sibhatu, Manuel Kassaye, Godebo, Melaku Gebremichael, Abdulahi, Ilili Jemal, Liyew, Tewodros Worku, Minas, Seye Mesfin, Bryce, Emily, Ashengo, Tigistu Adamu, Varallo, John
Format: Article
Language:English
Subjects:
Audits
Checklists
Collaboration
Continuous quality improvement
Developing countries
Documentation
Health facilities
Intervention
LDCs
Low income groups
Mortality
Patient safety
Public health
Quality improvement
Quality Improvement Report
Surgery
Surgical outcomes
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Summary:BackgroundIn 2009, the WHO introduced the surgical safety checklist (SSC) as one of the interventions for improving patient safety. The systematic use of structured checklists during surgery has been shown to reduce perioperative morbidity and mortality. However, SSC utilisation has been challenging in low-income and middle-income countries, including Ethiopia. Jhpiego Ethiopia implemented a quality improvement project (QIP) aimed to increase SSC utilisation.MethodologyA model for improvement was used to design and implement a collaborative QIP to improve SSC utilisation at 23 public health facilities (13 primary health care facilities, 4 general hospitals and 6 tertiary hospitals) in Ethiopia from October 2020 to September 2021. SSC utilisation was defined as when a patient chart had SSC attached and each part of the checklist was completed. Training of surgical staff on safe surgery packages, monthly clinical mentorship and cluster-based learning platforms were implemented during the study period. We analysed bimonthly chart audit reports from each facility to assess the proportion of surgeries where the SSC was used. Shewhart charts were used to conduct a time-series analysis. Additionally, the Z-test for two sample proportions was used to determine if there is a statistically significant change from the baseline measure with a p
ISSN:2399-6641
2399-6641
DOI:10.1136/bmjoq-2023-002406