No abstract

Both tools demonstrated substantial IRR and required limited training to use. These instruments may be used to observe checklist performance and teamwork in the operating room. However, further refinement and calibration of observer expectations, particularly in rating teamwork, could improve the utility of the tools.

It is possible to meaningfully assess hospital management practices in low resource settings. We observed substantial variation in implementation of basic management practices at the three hospitals. Future research should focus on whether enhancing management practices can improve surgical capacity and outcomes.