Implementation of a perioperative registry in Ethiopia to enhance surgical quality improvement

Author:

Jaraczewski Taylor J.1ORCID,Abebe Belay M.2,Diehl Thomas3,Esayas Tinbite2,Melaku Winta2,Nigussie Yonas2,Ahmed Kaleem S.3ORCID,Vo Tien3,Lee McKenzie4,Woisha Biruk2,Woldegiorgis Ermias Tadesse2,Chen Taylor H.1,Tegene Bereket A.2,Belachew Anteneh Gadisa25,Dodgion Christopher1,Iverson Katherine R.1,Tefera Girma3,Zafar Syed Nabeel3

Affiliation:

1. Department of Surgery Medical College of Wisconsin Milwaukee Wisconsin USA

2. Department of Surgery Hawassa University Comprehensive Specialized Hospital Hawassa Ethiopia

3. Department of Surgery University of Wisconsin‐Madison School of Medicine and Public Health Madison Wisconsin USA

4. Department of Surgery Virginia Commonwealth University Richmond Virginia USA

5. Department of Surgery University of Global Health Equity Burera Rwanda

Abstract

AbstractBackgroundDespite a glaring need and proven efficacy, prospective surgical registries are lacking in low‐ and middle‐income countries. The objective of this study was to design and implement a comprehensive prospective perioperative registry in a low‐income country.MethodsThis study was conducted at Hawassa University Comprehensive Specialized Hospital in Hawassa, Ethiopia. Design of the registry occurred from June 2021 to May 2022 and pilot implementation from May 2022 to May 2023. All patients undergoing elective or emergent general surgery were included. Following one year, operability and fidelity of the registry were analyzed by assessing capture rate, incidence of missing data, and accuracy.ResultsA total of 67 variables were included in the registry including demographics, preoperative, operative, post‐operative, and 30‐day data. Of 440 eligible patients, 226 (51.4%) were successfully captured. Overall incidence of missing data and accuracy was 5.4% and 90.2% respectively. Post pilot modifications enhanced capture rate to 70.5% and further optimized data collection processes.ConclusionThe establishment of a low‐cost electronic prospective perioperative registry in a low‐income country represents a significant step forward in enhancing surgical care in under‐resourced settings. The initial success of this registry highlights the feasibility of such endeavors when strong partnerships and local context are at the center of implementation. Continuous efforts to refine this registry are ongoing, which will ultimately lead to enhanced surgical quality, research output, and expansion to other sites.

Publisher

Wiley

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