The Utility of The Safe Surgery Organizational Readiness Tool Prior to Implementation of Trauma System Strengthening Interventions in Haiti

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Background Injuries are one of the leading causes of death worldwide; however, 90% of these deaths occur in low-and middle-income countries where trauma systems face significant barriers. Project Trauma Haiti (PROTRA Haiti) aims to enhance trauma care through a multistage initiative. The objective of this study was to assess perceptions of healthcare provider readiness to implement Primary Trauma Courses, Trauma Registries, and Morbidity & Mortality meetings at Hôpital de l’Université d’État d’Haïti (HUEH). Methods To evaluate readiness to implement quality improvement projects at the individual, team, and facility levels at HUEH, surgical team members were asked to complete the Safe Surgery Organizational Readiness Tool (SSORT). The SSORT is a validated tool that provides insight into organizational cultural domains that support planned quality improvement initiatives. Survey responses were analyzed, and mean scores and interquartile ranges were calculated for each domain. Responses were categorized as high readiness if the average was on a 5-point scale and low readiness if they were below 3. Results Twelve surgical team members at HUEH including surgical providers, anesthesia providers and surgical ward nurses completed the SSORT. Using a 5-point Likert scale, high readiness was observed in the domains of appropriateness (4.23/5), team valence (4.22/5), team efficacy (4.00/5), team learning orientation (3.98/5), learning environment (3.33/5), and vision of sustainability (3.17/5). The domain of resistance to change, which had an inverse score, had a mean score of 1.52, indicating low levels of individual resistance to change. However, facility capacity (2.03/5) and communication about change (2.91/5) exhibited lower readiness, highlighting potential implementation challenges. Conclusion Our results reveal that surgical team members strongly believed that interventions at HUEH were appropriate at individual and team levels. Before implementation, a new focus will be placed on discussions with facility leadership to address concerns facility support and resource needs. This study underscores the ability of the SSORT to evaluate multilevel readiness before implementing health system-strengthening interventions.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.