Assessment of Hospitals Readiness in Implementing a Non-Technical Skills for Surgery Training Program: A...

Area of Science:

• Healthcare Management
• Surgical Safety
• Patient Care Quality

Background:

• Non-technical skills for Surgeons (NOTSS) are crucial for intraoperative patient safety.
• Sustaining the implementation of NOTSS training programs requires understanding organizational readiness.
• This study addresses the need to assess and investigate factors influencing NOTSS implementation sustainability.

Purpose of the Study:

• To quantitatively evaluate perioperative providers' perceptions of hospital readiness for sustained NOTSS implementation.
• To qualitatively explore factors influencing the successful implementation of NOTSS training programs.

Main Methods:

• A mixed-methods study was conducted in 11 Rwandan hospitals (March 2022-October 2023).
• Quantitative data collected using the Safe Surgery Organizational Readiness Tool (SSORT) and Safety Attitude Questionnaire post-refresher course.
• Qualitative data gathered through semi-structured interviews and focus groups with trained perioperative providers.

Main Results:

• 477 participants (94.5% response rate) completed the survey; 51.9% were female.
• Overall SSORT score was 4.01 (IQR: 3.68-4.28), with high perceived appropriateness of NOTSS training (Median 5, IQR: 4.5-5).
• Satisfaction with hospital readiness correlated with safety climate (aOR: 1.02) and teamwork climate (aOR: 1.05).
• Qualitative themes: NOTSS appropriateness for patient safety, understaffing challenges, leadership support, and resource limitations.

Conclusions:

• Perioperative providers in Rwanda view NOTSS training as appropriate and leadership-endorsed.
• Insufficient resources and work overload negatively impact perceived hospital capacity for NOTSS implementation.
• Addressing resource and staffing issues is key to sustaining NOTSS training and improving patient safety.