Improving Perioperative Mortality Rate Data Capture in Hawassa, Ethiopia: A Mixed-Methods Study

Area of Science:

• Global Health
• Surgical Outcomes
• Health Informatics

Background:

• Ethiopia's 2015 national plan to enhance surgical capacity.
• Implementation of surgical indicators for progress monitoring.
• Focus on perioperative mortality rate (POMR) in the Sidama region's largest referral hospital.

Purpose of the Study:

• Investigate the perioperative mortality rate (POMR).
• Compare POMR data across multiple sources.
• Evaluate data collection practices and challenges.

Main Methods:

• Defined perioperative mortality as death post-major surgery before discharge.
• Extracted surgical deaths and volume data (July 2022-May 2023).
• Compared POMR from paper registries, discharge info, HMIS, and DHIS2.
• Conducted qualitative interviews with 17 healthcare professionals and data officers.

Main Results:

• Reported 1-year POMR varied: 0.9% (registries), 0.9% (discharge info), 0.5% (HMIS), 0.6% (DHIS2).
• Interviews revealed regular tracking but highlighted lack of electronic systems as a barrier.
• Proposed solutions included improved data quality monitoring, training, and equipment.

Conclusions:

• Discrepancies in POMR data stem from inconsistent entry and lack of consolidated postoperative death tracking.
• A well-trained workforce and a digital record system are crucial for improving POMR data capture.
• Addressing data collection challenges is vital for effective surgical outcome monitoring.