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Summary Background Perioperative processes have a great impact on the quality of surgery. In a high-risk surrounding, proper planning and communication is of upmost importance. We have identified other professions next to surgery with comparable circumstances and conducted a survey to elaborate on the impact of perioperative processes. Objective To identify standards in preoperative planning in high-risk professions and determine possible shortcomings in surgical practice. Methods Two surveys were constructed and distributed to surgeons, mountain guides, and soldiers. Questions were designed to investigate preoperative planning behavior and compare the different professions. Results Nearly every participant (97%) agreed to the fact that preoperative planning helps to avoid complications. Most surgeons agreed that the preoperative and postoperative phase of care had the greatest ability to improve overall quality of care. The opinions about planning were divided. The minority of surgeons agreed to the importance of sharing a plan preoperatively. Soldiers were the profession with the highest rate of plan sharing. Conclusion The readiness to communicate varies between professions and is lowest for surgeons. Missing standardization of procedures and the surgeon’s ego might be explanations for this behavior. Interventions to overcome this shortcoming, like the preoperative team timeout, have already been implemented but further improvements are needed.

This paper summarises the results of a study which examined international experience with regard to community-based health financing (CBHF) schemes, scaling up CBHF schemes, and the feasibility of scaling up community-based health insurance (CBHI) in Armenia. It was based on a literature review of international experience and qualitative research in Armenia. The recommendations derived from this study have relevance both for Armenia and for the use of CBHI schemes as a tool for promoting pro-poor health system reform in low-resource settings more generally.