Enhancing surgical safety checklist utilization at a rural primary hospital through a quality improvement project (QIP) (CASE DELIVERY AND PRACTICE IMPROVEMENT)
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Title
Enhancing surgical safety checklist utilization at a rural primary hospital through a quality improvement project (QIP) (CASE DELIVERY AND PRACTICE IMPROVEMENT)
Subject
quality improvement (QI); Surgical Safety Checklist; patient safety
Description
Background: Despite evidence demonstrating various benefits of the World Health Organization (WHO) Surgical Safety Checklist (SSC), its
utilization is less frequent in low- and middle-income countries (LMICs). This quality improvement project (QIP) was conducted at a rural primary
hospital in Ethiopia to address suboptimal utilization of the SSC. At baseline, an average SSC utilization rate was 50% and a completion rate
was 80% over the prior 6 months (October 2023–March 2024).
Objective: This study aimed to enhance the utilization and completion rates of the WHO SSC through a structured QIP.
Methods: A single-cycle Plan-Do-Study-Act approach was employed to enhance adherence. Key interventions included translating the SSC into
Amharic, conducting a two-day training session, introducing pre- and postoperative briefings, and requiring surgeons to remain in the operation
theater until checklist completion. Biweekly audits and supervision were conducted to monitor progress. Key performance indicators were SSC
utilization and completion rates, while secondary indicators included the rate of prophylactic antibiotic administration and SSI. Trend analysis
using run charts evaluated changes over time, while staff interviews provided insights into behavioral and attitudinal shifts.
Results: The QIP demonstrated a significant and sustained improvements. Baseline measurements in October 2023 showed a utilization rate
of 50% and a completion rate of 80%. Following targeted interventions, both metrics steadily improved, reaching 100% by June 2024 and
maintaining this level through September 2024.
Conclusion: The QIP demonstrated that achieving 100% utilization and completion of the WHO SSC is feasible even in rural hospitals of LMICs.
Formal training proved crucial for improving adherence, addressing gaps seen with informal approaches. This underscores the value of structured,
localized interventions for improving surgical safety practices and encourages broader adoption in similar contexts. To sustain the results, ongoing
supportive training, monthly supervision, and staff recognition initiatives were initiated.
utilization is less frequent in low- and middle-income countries (LMICs). This quality improvement project (QIP) was conducted at a rural primary
hospital in Ethiopia to address suboptimal utilization of the SSC. At baseline, an average SSC utilization rate was 50% and a completion rate
was 80% over the prior 6 months (October 2023–March 2024).
Objective: This study aimed to enhance the utilization and completion rates of the WHO SSC through a structured QIP.
Methods: A single-cycle Plan-Do-Study-Act approach was employed to enhance adherence. Key interventions included translating the SSC into
Amharic, conducting a two-day training session, introducing pre- and postoperative briefings, and requiring surgeons to remain in the operation
theater until checklist completion. Biweekly audits and supervision were conducted to monitor progress. Key performance indicators were SSC
utilization and completion rates, while secondary indicators included the rate of prophylactic antibiotic administration and SSI. Trend analysis
using run charts evaluated changes over time, while staff interviews provided insights into behavioral and attitudinal shifts.
Results: The QIP demonstrated a significant and sustained improvements. Baseline measurements in October 2023 showed a utilization rate
of 50% and a completion rate of 80%. Following targeted interventions, both metrics steadily improved, reaching 100% by June 2024 and
maintaining this level through September 2024.
Conclusion: The QIP demonstrated that achieving 100% utilization and completion of the WHO SSC is feasible even in rural hospitals of LMICs.
Formal training proved crucial for improving adherence, addressing gaps seen with informal approaches. This underscores the value of structured,
localized interventions for improving surgical safety practices and encourages broader adoption in similar contexts. To sustain the results, ongoing
supportive training, monthly supervision, and staff recognition initiatives were initiated.
Creator
MelakuTeshale Gemechu, Anteneh Cheru Adinew, Elias Ermias Ledamo
Source
DOI:https://doi.org/10.1093/ijcoms/lyaf004
Publisher
Oxford University Press
Date
16 April 2025
Contributor
Sri Wahyuni
Format
PDF
Language
English
Type
Text
Files
Collection
Citation
MelakuTeshale Gemechu, Anteneh Cheru Adinew, Elias Ermias Ledamo, “Enhancing surgical safety checklist utilization at a rural primary hospital through a quality improvement project (QIP) (CASE DELIVERY AND PRACTICE IMPROVEMENT),” Repository Horizon University Indonesia, accessed February 21, 2026, https://repository.horizon.ac.id/items/show/11298.