Outcome Measurement at a Ugandan Referral Hospital: Validation of the Mbarara Surgical Services Quality Assurance Database

Drevin, Gustaf; Albutt, Katherine; Baluku, Moris; Tuhumwiire, Caleb; Deng, Hao; Musinguzi, Nicholas; Modest, Vicki E.; Ngonzi, Joseph; Ttendo, Stephen; Firth, Paul G.

doi:10.1007/s00268-020-05537-8

Cited by 3 publications

(3 citation statements)

References 56 publications

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“…An evaluation of this analog logbook system performed in 2016 by Svendsen and Helgerud et al [ 14 ] identified inaccuracies and labor-intensive follow-up and recommended the development of a fully digital e-logbook. This recommendation was supported by a study in Uganda that reported that an electronic database captured 97.5% of the operation logbook entries [ 15 ].…”

Section: Methodsmentioning

confidence: 88%

Early evaluation of the transition from an analog to an electronic surgical logbook system in Sierra Leone

et al. 2021

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Background Surgical logbooks are a commonly used tool for quality assurance of surgical training. Electronic logbooks are increasingly applied in low-resource settings, but there is limited research on their quality. The aim of this study is to evaluate the quality of an app-based surgical e-logbook system shortly after its implementation in a low-income country and to identify potential areas of improvement for the system. Methods Entries in the e-logbook system were cross-checked with hospital records and categorized as matched or overreported. Moreover, the hospital records were checked for underreported procedures. Additionally, semi-structured interviews were conducted with users of the e-logbook system. Results A total of 278 e-logbook database entries and 379 procedures in the hospital records from 14 users were analyzed. Matches were found in the hospital records for 67.3% of the database entries. Moreover, 32.7% of the database entries were overreported and 50.7% of the procedures in the hospital records were underreported. A previous study of an analog surgical logbook system in the same setting estimated that 73.1% of the entries were matches or close matches. Interviews with 12 e-logbook users found overall satisfaction but also identified potential areas of improvement, including the need for more training in the use of the system, modifications to improve user-friendliness, and better access to the necessary technology. Conclusions A reliable documentation system is necessary to evaluate the quality of health workforce training. The early evaluation of a surgical e-logbook system in a low-income country showed that the collected data should be approached with caution. The quantitative analysis suggests that the e-logbook system needs to be improved in terms of accuracy. In interviews, users reported that digitalization of the logbook system was a much-needed innovation but also identified important areas of improvement. Recognition of these aspects at an early stage facilitates guidance and adjustment of further implementation and might improve the accuracy of the system.

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Section: Methodsmentioning

confidence: 88%

Early evaluation of the transition from an analog to an electronic surgical logbook system in Sierra Leone

et al. 2021

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“…The completeness of population capture, the accuracy and completeness of data extraction, and the reliability of procedure coding were externally validated. [13][14][15] The database is housed on a server in the hospital. Staffing included 5 data clerks/coders, an operations manager, and an information technology expert/statistician.…”

Section: Database Methodologymentioning

confidence: 99%

“…The completeness of population capture, the accuracy and completeness of data extraction, and the reliability of procedure coding were externally validated. 13–15…”

Section: Methodsmentioning

confidence: 99%

Surgical, Obstetric, and Anesthetic Mortality Measurement at a Ugandan Secondary Referral Hospital

Firth

Mushagara

Musinguzi

et al. 2021

Anesthesia &Amp; Analgesia

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BACKGROUND: The health care systems of low-income countries have severely limited capacity to treat surgical diseases and conditions. There is limited information about which hospital mortality outcomes are suitable metrics in these settings. METHODS: We did a 1-year observational cohort study of patient admissions to the Surgery and the Obstetrics and Gynecology departments and of newborns delivered at a Ugandan secondary referral hospital. We examined the proportion of deaths captured by standardized metrics of mortality. RESULTS: There were 17,015 admissions and 9612 deliveries. A total of 847 deaths were documented: 385 (45.5%) admission deaths and 462 (54.5%) perinatal deaths. Less than one-third of admission deaths occurred during or after an operation (n = 126/385, 32.7%). Trauma and maternal mortality combined with perioperative mortality produced 79.2% (n = 305/385) of admission deaths. Of 462 perinatal deaths, 412 (90.1%) were stillborn, and 50 (10.9%) were early neonatal deaths. The combined metrics of the trauma mortality rate, maternal mortality ratio, thirty-day perioperative mortality rate, and perinatal mortality rate captured 89.8% (n = 761/847) of all deaths documented at the hospital. CONCLUSIONS: The combination of perinatal, maternal, trauma, and perioperative mortality metrics captured most deaths documented at a Ugandan referral hospital.

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The structure, function and implementation of an outcomes database at a Ugandan secondary hospital: the Mbarara Surgical Services Quality Assurance Database

Firth

Ngonzi

Mushagara

et al. 2022

Southern African Journal of Anaesthesia and Analgesia

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Outcome Measurement at a Ugandan Referral Hospital: Validation of the Mbarara Surgical Services Quality Assurance Database

Cited by 3 publications

References 56 publications

Early evaluation of the transition from an analog to an electronic surgical logbook system in Sierra Leone

Early evaluation of the transition from an analog to an electronic surgical logbook system in Sierra Leone

Surgical, Obstetric, and Anesthetic Mortality Measurement at a Ugandan Secondary Referral Hospital

The structure, function and implementation of an outcomes database at a Ugandan secondary hospital: the Mbarara Surgical Services Quality Assurance Database

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