Jhpiego, Addis Ababa, Ethiopia.
Federal Ministry of Heath, Addis Ababa, Ethiopia.
BMC Health Serv Res. 2024 Jul 26;24(1):851. doi: 10.1186/s12913-024-11303-6.
The effective management of surgical and anesthesia care relies on quality data and its readily availability for both patient-centered decision-making and facility-level improvement efforts. Recognizing this critical need, the Strengthening Systems for Improved Surgical Outcomes (SSISO) project addressed surgical care data management and information use practices across 23 health facilities from October 2019 to September 2022. This study aimed to evaluate the effectiveness of SSISO interventions in enhancing practices related to surgical data capture, reporting, analysis, and visualization.
This study employed a mixed method, pre- post intervention evaluation design to assess changes in data management and utilization practices at intervention facilities. The intervention packages included capacity building trainings, monthly mentorship visits facilitated by a hub-and-spoke approach, provision of data capture tools, and reinforcement of performance review teams. Data collection occurred at baseline (February - April 2020) and endline (April - June 2022). The evaluation focused on the availability and appropriate use of data capture tools, as well as changes in performance review practices. Appropriate use of registers was defined as filling all the necessary data onto the registers, and this was verified by completeness of selected key data elements in the registers.
The proportion of health facilities with Operation Room (OR) scheduling, referral, and surgical site infection registers significantly increased by 34.8%, 56.5% and 87%, respectively, at project endline compared to baseline. Availability of OR and Anesthesia registers remained high throughout the project, at 91.3% and 95.6%, respectively. Furthermore, the appropriate use of these registers improved, with statistically significant increases observed for OR scheduling registers (34.8% increase). Increases were also noted for OR register (9.5% increase) and anesthesia register (4.5% increase), although not statistically significant. Assessing the prior three months reports, the report submissions to the Ministry of Health/Regional Health Bureau (MOH/RHB) rose from 85 to 100%, reflecting complete reporting at endline period. Additionally, the proportion of surgical teams analyzing and displaying data for informed decision-making significantly increased from 30.4% at baseline to 60.8% at endline period.
The implemented interventions positively impacted surgical data management and utilization practice at intervention facilities. These positive changes were likely attributable to capacity building trainings and regular mentorship visits via hub-and-spoke approach. Hence, we recommend further investigation into the effectiveness of similar intervention packages in improving surgical data management, data analysis and visualization practices in low- and middle-income country settings.
有效的外科和麻醉护理管理依赖于高质量的数据，这些数据可用于患者为中心的决策和医疗机构层面的改进工作。认识到这一关键需求，强化手术结果改善系统（SSISO）项目针对 2019 年 10 月至 2022 年 9 月期间 23 家卫生机构的外科护理数据管理和信息使用实践进行了干预。本研究旨在评估 SSISO 干预措施在增强与外科数据采集、报告、分析和可视化相关的实践方面的有效性。
本研究采用混合方法、干预前后评估设计，评估干预设施中外科数据管理和利用实践的变化。干预方案包括能力建设培训、通过轮辐式方法提供每月指导访问、提供数据采集工具以及加强绩效审查团队。数据收集在基线（2020 年 2 月至 4 月）和终点（2022 年 4 月至 6 月）进行。评估重点是数据采集工具的可用性和适当使用情况，以及绩效审查实践的变化。寄存器的适当使用定义为在寄存器上填写所有必要的数据，这通过在寄存器中选择的关键数据元素的完整性来验证。
与基线相比，项目结束时，手术室（OR）排班、转诊和手术部位感染登记册的卫生机构比例分别显著增加了 34.8%、56.5%和 87%。OR 和麻醉登记册的可用性在整个项目中一直保持在较高水平，分别为 91.3%和 95.6%。此外，这些登记册的适当使用有所改善，手术室排班登记册的使用显著增加（增加 34.8%）。OR 登记册（增加 9.5%）和麻醉登记册（增加 4.5%）也有所增加，尽管没有统计学意义。评估前三个月的报告，向卫生部/区域卫生局（MOH/RHB）提交的报告比例从 85%上升到 100%，反映了期末的完整报告。此外，分析和显示数据以做出知情决策的外科团队的比例从基线的 30.4%显著增加到期末的 60.8%。
实施的干预措施对外科数据管理和干预设施中的利用实践产生了积极影响。这些积极的变化可能归因于能力建设培训和通过轮辐式方法提供的定期指导访问。因此，我们建议进一步调查类似干预方案在改善低中等收入国家外科数据管理、数据分析和可视化实践方面的有效性。
