Development and content validation of the Safe Surgery Organizational Readiness Tool: A quality improvement study

Hayirli, Tuna Cem; Meara, John G.; Barash, David; Chirangi, Bwire; Hellar, Augustino; Kenemo, Benard; Kissima, Innocent; Maongezi, Sarah; Reynolds, Cheri; Samky, Hendry; Ulisubisya, Mpoki; Varallo, John; Warinner, Chloe; Alidina, Shehnaz; Kapologwe, Ntuli

doi:10.1016/j.ijsu.2021.105944

Cited by 5 publications

(9 citation statements)

References 43 publications

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“…To understand the impact of mentorship on surgical access and quality and its sustainability, experimental and longitudinal research design should be considered in the future. Further research is necessary to understand factors such as optimal dose, the importance of readiness for change for success [82], and which contextual factors, resources, and structures are important. Research can inform the optimal design of the intervention, how to adapt it based on the implementation context, uncover best practices, and measure impact [83][84][85][86].…”

Section: Future Researchmentioning

confidence: 99%

Implementing surgical mentorship in a resource-constrained context: a mixed methods assessment of the experiences of mentees, mentors, and leaders, and lessons learned

et al. 2022

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Background A well-qualified workforce is critical to effective functioning of health systems and populations; however, skill gaps present a challenge in low-resource settings. While an emerging body of evidence suggests that mentorship can improve quality, access, and systems in African health settings by building the capacity of health providers, less is known about its implementation in surgery. We studied a novel surgical mentorship intervention as part of a safe surgery intervention (Safe Surgery 2020) in five rural Ethiopian facilities to understand factors affecting implementation of surgical mentorship in resource–constrained settings. Methods We designed a convergent mixed-methods study to understand the experiences of mentees, mentors, hospital leaders, and external stakeholders with the mentorship intervention. Quantitative data was collected through a survey (n = 25) and qualitative data through in-depth interviews (n = 26) in 2018 to gather information on (1) intervention characteristics including areas of mentorship, mentee-mentor relationships, and mentor characteristics, (2) organizational context including facilitators and barriers to implementation, (3) perceived impact, and (4) respondent characteristics. We analyzed the quantitative and qualitative data using frequency analysis and the constant comparison method, respectively; we integrated findings to identify themes. Results All mentees (100%) experienced the intervention as positive. Participants perceived impact as: safer and more frequent surgical procedures, collegial bonds between mentees and mentors, empowerment among mentees, and a culture of continuous learning. Over 70% of all mentees reported their confidence and job satisfaction increased. Supportive intervention characteristics included a systems focus, psychologically safe mentee-mentor relationships, and mentor characteristics including generosity with time and knowledge, understanding of local context, and interpersonal skills. Supportive organizational context included a receptive implementation climate. Intervention challenges included insufficient clinical training, inadequate mentor support, and inadequate dose. Organizational context challenges included resource constraints and a lack of common understanding of the intervention. Conclusion We offer lessons for intervention designers, policy makers, and practitioners about optimizing surgical mentorship interventions in resource-constrained settings. We attribute the intervention’s success to its holistic approach, a receptive climate, and effective mentee-mentor relationships. These qualities, along with policy support and adapting the intervention through user feedback are important for successful implementation.

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Section: Future Researchmentioning

confidence: 99%

Implementing surgical mentorship in a resource-constrained context: a mixed methods assessment of the experiences of mentees, mentors, and leaders, and lessons learned

et al. 2022

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“…14 One determinant is the preimplementation readiness of surgical facilities, both in terms of organizational characteristics as well as facility infrastructure. 15 The concept of organizational readiness for change has become increasingly important in implementation science. While readiness encompasses a variety of complex social, psychological, and contextual components, more simply, readiness refers to a state of being prepared for future actions.…”

Section: Introductionmentioning

confidence: 99%

“…While the issue of readiness is not exclusive to LMICs, assessing these characteristics can provide setting‐specific evidence for scaling quality improvement interventions in LMICs. The Safe Surgery Organizational Readiness Tool (SSORT) was developed to evaluate surgical facility members' baseline beliefs and attitudes toward quality improvement and safety interventions in surgical care 15 . The goal of this assessment is to identify potential barriers to implementation such that interventions can be better tailored to promote success.…”

Section: Introductionmentioning

confidence: 99%

“…The Safe Surgery Organizational Readiness Tool (SSORT) was developed to evaluate surgical facility members' baseline beliefs and attitudes toward quality improvement and safety interventions in surgical care. 15 The goal of this assessment is to identify potential barriers to implementation such that interventions can be better tailored to promote success.…”

Section: Introductionmentioning

confidence: 99%

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Increasing access to pediatric surgical care: Assessing district hospital readiness in rural Rwanda

Nuss,

Nkurunziza,

Mugabo

et al. 2024

World j. surg.

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Introduction/BackgroundSafe and quality surgery is crucial for child health. In Rwanda, district hospitals serve as primary entry points for pediatric patients needing surgical care. This paper reports on the organizational readiness and facility capacity to provide pediatric surgery in three district hospitals in rural Rwanda.MethodsWe administered the Children's Surgical Assessment Tool, adapted for a Rwandan district hospital, to assess facility readiness across 5 domains (infrastructure, workforce, service delivery, financing, and training) at three Partners in Health supported district hospitals (Kirehe, Rwinkwavu, and Butaro District Hospitals). We used the Safe Surgery Organizational Readiness Tool (SSORT) to measure perceived individual and team readiness to implement surgical quality improvement interventions across 14 domains.ResultsNone of the facilities had a dedicated pediatric surgeon, and the most common barriers to pediatric surgery were lack of surgeon (68%), lack of physician anesthesiologists (19%), and inadequate infrastructure (17%). There were gaps in operating and recovery room infrastructure and information management for pediatric outpatients and referrals. In SSORT interviews (n = 47), the highest barriers to increasing pediatric surgery capacity were facility capacity (mean score = 2.6 out of 5), psychological safety (median score = 3.0 out of 5), and resistance to change (mean score = 1.5 out of 5 with 5 = no resistance).ConclusionsThis study highlights challenges in providing safe and high‐quality surgical care to pediatric patients in three rural district hospitals in Rwanda. It underscores the need for targeted interventions to address facility and organizational barriers prior to implementing interventions to expand pediatric surgical capacity.

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“…Data shows that even in low resource settings, a culture of safety is critical to optimizing outcomes (24, 25). Furthermore, the Model for Improvement (Plan-Do-Study-Act) is a model that is applicable at the microsystems level and allows for incremental quality improvement even in resourcelimited settings (26). Every pathology department should train and designate an individual responsible for departmental quality and patient safety.…”

Section: Introductionmentioning

confidence: 99%

Addressing quality and safety in anatomic pathology in low- and middle-income countries

Smith

Eadara²,

Parkash³

2022

Front. Med.

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The World Health Organization (WHO) has created a sustainable development goal of reducing preventable mortality from cancer in low- and middle-income countries (LMICs) by 30% by 2030. Central to achieving this goal is the creation and maintenance of quality anatomic pathology services (APS). Within the last decade, quality assurance programs and patient safety measures have become a major focus of research for upper middle- and high-income countries (UMHICs), which has led to marked documented improvement in the quality of services provided by laboratories, as well as a decrease in patient safety events. We propose that as APS are developed in LMICs, the lessons learned by UMHICs are necessary to incorporate to produce quality and safe services toward obtaining the aforementioned goal. Furthermore, data suggests that Quality Improvement work requires change at the macrosystems and microsystems levels to achieve these goals. Here, we propose five “microsystems” strategies for professional organizations, healthcare institutions in LMICs and UMHICs that would accelerate quality improvement programs/systems implementation in APS in LMICs.

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Development and content validation of the Safe Surgery Organizational Readiness Tool: A quality improvement study

Cited by 5 publications

References 43 publications

Implementing surgical mentorship in a resource-constrained context: a mixed methods assessment of the experiences of mentees, mentors, and leaders, and lessons learned

Implementing surgical mentorship in a resource-constrained context: a mixed methods assessment of the experiences of mentees, mentors, and leaders, and lessons learned

Increasing access to pediatric surgical care: Assessing district hospital readiness in rural Rwanda

Addressing quality and safety in anatomic pathology in low- and middle-income countries

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