article · Anaesthesia
A south-south collaboration established a clinician-led, real-time, cloud-based peri-operative registry across four hospitals in Ethiopia. Operating across 285 beds in Addis Ababa and the Amhara and Southern Nations Nationalities and Peoples regions, the system recorded 1,748 consecutive surgical procedures between April 2019 and April 2020. The registry linked peri-operative data, including metrics from a national safe surgery programme, directly to live dashboards that track service utilisation, access to surgery, and care quality. Documented metrics showed a 92.1 percent adherence rate to the World Health Organization Surgical Safety Checklist, alongside low rates of anaesthesia-related adverse events and surgical site infections. The platform demonstrates that digital registries can effectively track performance indicators in resource-limited environments and is expanding across additional administrative areas to support healthcare improvement.
In settings with limited resources, disparities in surgical quality and access contribute significantly to preventable mortality. Establishing digital registries provides healthcare workers and health ministries with real-time, granular data on patient outcomes and clinical safety. This transparency helps hospitals track essential quality standards, identify service gaps, and guide targeted clinical improvements to make surgery safer.
The work presents an applied and tested digital health solution already functioning in clinical environments and expanding across regional administrations. It enables health systems, hospital administrators, and clinical teams to deploy context-specific peri-operative tracking dashboards. The tool represents an operational public health technology suitable for integration into national health information architectures or adaptation by digital health providers supporting hospital management systems in emerging markets.
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In resource-constrained settings, where inequalities in access to and quality of surgical care results in excess mortality, peri-operative care registries are uncommon. A south-south collaboration supported the implementation of a context specific, clinician-led, multicentre real-time peri-operative registry in Ethiopia. Peri-operative information, including the Ethiopian Ministry of Health's national 'Saving Lives through Safe Surgery initiative', was linked to real-time dashboards, providing clinicians and administrators with information on service utilisation, surgical access, national surgical key performance indicators and measures of quality of care. We recruited four hospitals representing 285 in-patient beds from the Amhara and Southern Nations Nationalities and Peoples regions and Addis Ababa city, and reported on 1748 consecutive surgical cases from April 2019 to April 2020. Key performance indicators included: compliance with the World Health Organization's Surgical Safety Checklist in 1595 (92.1%) surgical cases; adverse events during anaesthesia in 33 (3.1%) cases; and surgical site infections in 21 (2.0%) patients. This collaboration has successfully implemented a multicentre digital surgical registry that can enable measurement of key performance indicators for surgery and evaluation of peri-operative outcomes. The peri-operative registry is currently being rolled out across the Amhara region and Addis Ababa city administration. It will provide continuous granular healthcare information necessary to empower clinicians to drive context-specific priorities for service improvement and research, in collaboration with national stakeholders and international research consortiums.
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DOI: 10.1111/anae.15394
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