@article{TEXTUAL,
      recid = {7189},
      author = {Henry, Jaymie Claire and Wong, Lye-Yeng and Reyes, Ana M.  and Jin, James Z. and Ferguson, Mark K. and Yip, Cheng Har  and Hill, Andrew},
      title = {Achieving global surgical excellence: An evidence-based  framework to guide surgical quality improvement programs in  low and middle income countries},
      journal = {Frontiers in Health Services},
      address = {2023-08-07},
      number = {TEXTUAL},
      abstract = {&lt;p&gt;Objectives: There is a lack of evidence-based  guidelines for enhancing global surgical care delivery. We  propose a set of recommendations to serve as a framework to  guide surgical quality improvement and scale-up initiatives  in low and middle income countries (LMICs).&lt;/p&gt; &lt;p&gt;Methods:  From January-December 2019, we reviewed the available  literature and their application toward LMIC settings. The  first initiative was the establishment of Best Practices  Recommendations intended to summarize best-level evidence  around quality improvement processes that have shown to  decrease morbidity and mortality in LMICs. The GRADE level  of evidence and strength of the recommendation were  assigned in accordance with the WHO handbook for guidelines  development. The second initiative was the scale-up of  principles and practices by establishing international  expert consensus on the optimal organization of surgical  services in LMICs using a modified Delphi methodology.&lt;/p&gt;  &lt;p&gt;Results: Recommendations for three topic areas were  established: reducing surgical site infections, improving  quality of trauma systems, and interventions to reduce  maternal and perinatal mortality. 27 studies were included  in a quantitative synthesis and meta-analysis for  interventions reducing surgical site infections, 27 studies  for interventions improving the quality of trauma systems,  and 14 studies for interventions reducing maternal and  perinatal mortality. Using Delphi methodology, an  international expert panel established consensus that  district hospitals should place the highest priority on  developing surgical services for low complexity, high  volume conditions. At the national level, emergency and  essential surgical care should be integrated within  national Universal Health Coverage frameworks.&lt;/p&gt;  &lt;p&gt;Conclusions: This project fills a critical cap in the  rapidly developing field of global surgery: gathering  evidence-based, practical, and cost-effective solutions  that will serve as a guide for the efficient planning and  allocation of resources necessary to promote quality and  safe essential surgical services in LMICs.&lt;/p&gt;},
      url = {http://knowledge.uchicago.edu/record/7189},
}