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2. Organizational learning in surgery in Tanzania's health system: a descriptive cross-sectional study.

Author

Alidina, Shehnaz, Hayirli, Tuna Cem, Amiri, Adam, Barash, David, Chwa, Cindy, Hellar, Augustino, Kengia, James T, Kissima, Innocent, Mayengo, Caroline D, Meara, John G, Mwita, Winfrida C, Staffa, Steven J, Tibyehabwa, Leopold, Wurdeman, Taylor, and Kapologwe, Ntuli A

Abstract

Organizational learning is critical for delivering safe, high-quality surgical care, especially in low- and middle-income countries (LMICs) where perioperative outcomes remain poor. While current investments in LMICs prioritize physical infrastructure, equipment, and staffing, investments in organizational learning are equally important to support innovation, creativity, and continuous improvement of surgical quality. This study aims to assess the extent to which health facilities in Tanzania's Lake Zone perform as learning organizations from the perspectives of surgical providers. The insights gained from this study can motivate future quality improvement initiatives and investments to improve surgical outcomes. We conducted a cross-sectional analysis using data from an adapted survey to explore the key components of organizational learning, including a supportive learning environment, effective learning processes, and encouraging leadership. Our sample included surgical team members and leaders at 20 facilities (health centers, district hospitals, and regional hospitals). We calculated the average of the responses at individual facilities. Responses that were 5+ on a 7-point scale or 4+ on a 5-point scale were considered positive. We examined the variation in responses by facility characteristics using a one-way ANOVA or Student's t -test. We used univariate and multiple regression to assess relationships between facility characteristics and perceptions of organizational learning. Ninety-eight surgical providers and leaders participated in the survey. The mean facility positive response rate was 95.1% (SD 6.1%). Time for reflection was the least favorable domain with a score of 62.5% (SD 35.8%). There was variation by facility characteristics including differences in time for reflection when comparing by level of care (P  = .02) and location (P  = .01), and differences in trying new approaches (P  = .008), capacity building (P  = .008), and information transfer (P  = .01) when comparing public versus faith-based facilities. In multivariable analysis, suburban centers had less time for reflection than urban facilities (adjusted difference = −0.48; 95% CI: −0.95, −0.01; P  = .046). Surgical team members reported more positive responses compared to surgical team leaders. We found a high overall positive response rate in characterizing organizational learning in surgery in 20 health facilities in Tanzania's Lake Zone. Our findings identify areas for improvement and provide a baseline for assessing the effectiveness of change initiatives. Future research should focus on validating the adapted survey and exploring the impact of strong learning environments on surgical outcomes in LMICs. Organizational learning is crucial in surgery and further research, funding, and policy work should be dedicated to improving learning cultures in health facilities. [ABSTRACT FROM AUTHOR]

Published
2024
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3. A multimodal mentorship intervention to improve surgical quality in Tanzania’s Lake Zone: a convergent, mixed methods assessment

Author

Alidina, Shehnaz, Tibyehabwa, Leopold, Alreja, Sakshie Sanjay, Barash, David, Bien-Aime, Danta, Cainer, Monica, Charles, Kevin, Ernest, Edwin, Eyembe, Joachim, Fitzgerald, Laura, Giiti, Geofrey C., Hellar, Augustino, Hussein, Yahaya, Kahindo, Furaha, Kenemo, Benard, Kihunrwa, Albert, Kisakye, Steve, Kissima, Innocent, Meara, John G., Reynolds, Cheri, Staffa, Steven J., Sydlowski, Meaghan, Varallo, John, Zanial, Noor, Kapologwe, Ntuli A., and Mayengo, Caroline Damian

Published
2021
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5. Reducing surgical site infections and mortality among obstetric surgical patients in Tanzania: a pre-evaluation and postevaluation of a multicomponent safe surgery intervention

Author

Ernest, Edwin Charles, primary, Hellar, Augustino, additional, Varallo, John, additional, Tibyehabwa, Leopold, additional, Bertram, Margaret Mary, additional, Fitzgerald, Laura, additional, Katoto, Adam, additional, Mshana, Stella, additional, Simba, Dorcas, additional, Gwitaba, Kelvin, additional, Boddu, Rohini, additional, Alidina, Shehnaz, additional, Giiti, Geofrey, additional, Kihunrwa, Albert, additional, Balandya, Belinda, additional, Urassa, David, additional, Hussein, Yahya, additional, Damien, Caroline, additional, Wackenreuter, Brendan, additional, Barash, David, additional, Morrison, Melissa, additional, Reynolds, Cheri, additional, Christensen, Alice, additional, and Makuwani, Ahmed, additional

Published
2021
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6. Outcomes of a multicomponent safe surgery intervention in Tanzania’s Lake Zone: a prospective, longitudinal study

Author

Alidina, Shehnaz, primary, Menon, Gopal, additional, Staffa, Steven J, additional, Alreja, Sakshie, additional, Barash, David, additional, Barringer, Erin, additional, Cainer, Monica, additional, Citron, Isabelle, additional, DiMeo, Amanda, additional, Ernest, Edwin, additional, Fitzgerald, Laura, additional, Ghandour, Hiba, additional, Gruendl, Magdalena, additional, Hellar, Augustino, additional, Jumbam, Desmond T, additional, Katoto, Adam, additional, Kelly, Lauren, additional, Kisakye, Steve, additional, Kuchukhidze, Salome, additional, Lama, Tenzing, additional, Lodge, William, additional, Maina, Erastus, additional, Massaga, Fabian, additional, Mazhiqi, Adelina, additional, Meara, John G, additional, Mshana, Stella, additional, Nason, Ian, additional, Reynolds, Chase, additional, Reynolds, Cheri, additional, Segirinya, Hannington, additional, Simba, Dorcas, additional, Smith, Victoria, additional, Strader, Christopher, additional, Sydlowski, Meaghan, additional, Tibyehabwa, Leopold, additional, Tinuga, Florian, additional, Troxel, Alena, additional, Ulisubisya, Mpoki, additional, Varallo, John, additional, Wurdeman, Taylor, additional, Zanial, Noor, additional, Zurakowski, David, additional, Kapologwe, Ntuli, additional, and Maongezi, Sarah, additional

Published
2021
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7. Additional file 3 of A multimodal mentorship intervention to improve surgical quality in Tanzania’s Lake Zone: a convergent, mixed methods assessment

Author

Alidina, Shehnaz, Tibyehabwa, Leopold, Alreja, Sakshie Sanjay, Barash, David, Bien-Aime, Danta, Cainer, Monica, Charles, Kevin, Ernest, Edwin, Eyembe, Joachim, Fitzgerald, Laura, Giiti, Geofrey C., Hellar, Augustino, Hussein, Yahaya, Kahindo, Furaha, Kenemo, Benard, Kihunrwa, Albert, Kisakye, Steve, Kissima, Innocent, Meara, John G., Reynolds, Cheri, Staffa, Steven J., Sydlowski, Meaghan, Varallo, John, Zanial, Noor, Kapologwe, Ntuli A., and Mayengo, Caroline Damian

Subjects
GeneralLiterature_MISCELLANEOUS
Abstract

Additional file 3: Overall experience, overall satisfaction and support for continuation of the mentorship program.

Published
2021
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8. Additional file 1 of A multimodal mentorship intervention to improve surgical quality in Tanzania’s Lake Zone: a convergent, mixed methods assessment

Author

Alidina, Shehnaz, Tibyehabwa, Leopold, Alreja, Sakshie Sanjay, Barash, David, Bien-Aime, Danta, Cainer, Monica, Charles, Kevin, Ernest, Edwin, Eyembe, Joachim, Fitzgerald, Laura, Giiti, Geofrey C., Hellar, Augustino, Hussein, Yahaya, Kahindo, Furaha, Kenemo, Benard, Kihunrwa, Albert, Kisakye, Steve, Kissima, Innocent, Meara, John G., Reynolds, Cheri, Staffa, Steven J., Sydlowski, Meaghan, Varallo, John, Zanial, Noor, Kapologwe, Ntuli A., and Mayengo, Caroline Damian

Abstract

Additional file 1: Mentorship survey.

Published
2021
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9. Additional file 4 of A multimodal mentorship intervention to improve surgical quality in Tanzania’s Lake Zone: a convergent, mixed methods assessment

Author

Alidina, Shehnaz, Tibyehabwa, Leopold, Alreja, Sakshie Sanjay, Barash, David, Bien-Aime, Danta, Cainer, Monica, Charles, Kevin, Ernest, Edwin, Eyembe, Joachim, Fitzgerald, Laura, Giiti, Geofrey C., Hellar, Augustino, Hussein, Yahaya, Kahindo, Furaha, Kenemo, Benard, Kihunrwa, Albert, Kisakye, Steve, Kissima, Innocent, Meara, John G., Reynolds, Cheri, Staffa, Steven J., Sydlowski, Meaghan, Varallo, John, Zanial, Noor, Kapologwe, Ntuli A., and Mayengo, Caroline Damian

Abstract

Additional file 4: Changes made resulting from the mentorship program.

Published
2021
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10. Additional file 6 of A multimodal mentorship intervention to improve surgical quality in Tanzania’s Lake Zone: a convergent, mixed methods assessment

Author

Alidina, Shehnaz, Tibyehabwa, Leopold, Alreja, Sakshie Sanjay, Barash, David, Bien-Aime, Danta, Cainer, Monica, Charles, Kevin, Ernest, Edwin, Eyembe, Joachim, Fitzgerald, Laura, Giiti, Geofrey C., Hellar, Augustino, Hussein, Yahaya, Kahindo, Furaha, Kenemo, Benard, Kihunrwa, Albert, Kisakye, Steve, Kissima, Innocent, Meara, John G., Reynolds, Cheri, Staffa, Steven J., Sydlowski, Meaghan, Varallo, John, Zanial, Noor, Kapologwe, Ntuli A., and Mayengo, Caroline Damian

Subjects
ComputingMilieux_GENERAL, ComputingMilieux_THECOMPUTINGPROFESSION, ComputingMilieux_COMPUTERSANDEDUCATION
Abstract

Additional file 6:Mentor characteristics desired by mentees and exhibited by mentors.

Published
2021
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11. Additional file 2 of A multimodal mentorship intervention to improve surgical quality in Tanzania’s Lake Zone: a convergent, mixed methods assessment

Author

Alidina, Shehnaz, Tibyehabwa, Leopold, Alreja, Sakshie Sanjay, Barash, David, Bien-Aime, Danta, Cainer, Monica, Charles, Kevin, Ernest, Edwin, Eyembe, Joachim, Fitzgerald, Laura, Giiti, Geofrey C., Hellar, Augustino, Hussein, Yahaya, Kahindo, Furaha, Kenemo, Benard, Kihunrwa, Albert, Kisakye, Steve, Kissima, Innocent, Meara, John G., Reynolds, Cheri, Staffa, Steven J., Sydlowski, Meaghan, Varallo, John, Zanial, Noor, Kapologwe, Ntuli A., and Mayengo, Caroline Damian

Subjects
ComputingMilieux_GENERAL
Abstract

Additional file 2: Interview protocols for mentees, mentors and facility leaders and focus group discussion questions.

Published
2021
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12. Improving surgical quality in low-income and middle-income countries: why do some health facilities perform better than others?

Author

Alidina, Shehnaz, primary, Chatterjee, Pritha, additional, Zanial, Noor, additional, Alreja, Sakshie Sanjay, additional, Balira, Rebecca, additional, Barash, David, additional, Ernest, Edwin, additional, Giiti, Geofrey Charles, additional, Maina, Erastus, additional, Mazhiqi, Adelina, additional, Mushi, Rahma, additional, Reynolds, Cheri, additional, Sydlowski, Meaghan, additional, Tinuga, Florian, additional, Maongezi, Sarah, additional, Meara, John G, additional, Kapologwe, Ntuli A, additional, Barringer, Erin, additional, Cainer, Monica, additional, Citron, Isabelle, additional, DiMeo, Amanda, additional, Fitzgerald, Laura, additional, Ghandour, Hiba, additional, Gruendl, Magdalena, additional, Hellar, Augustino, additional, Jumbam, Desmond T, additional, Katoto, Adam, additional, Kelly, Lauren, additional, Kisakye, Steve, additional, Kuchukhidze, Salome, additional, Lama, Tenzing N, additional, Menon, Gopal, additional, Mshana, Stella, additional, Reynolds, Chase, additional, Segirinya, Hannington, additional, Simba, Dorcas, additional, Smith, Victoria, additional, Staffa, Steven J, additional, Strader, Christopher, additional, Tibyehabwa, Leopold, additional, Troxel, Alena, additional, Varallo, John, additional, Wurdeman, Taylor, additional, and Zurakowski, David, additional

Published
2021
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13. A Team-Based Approach to Introduce and Sustain the Use of the WHO Surgical Safety Checklist in Tanzania

Author

Hellar, Augustino, primary, Tibyehabwa, Leopold, additional, Ernest, Edwin, additional, Varallo, John, additional, Betram, Margaret Mary, additional, Fitzgerald, Laura, additional, Giiti, Geofrey, additional, Kihundrwa, Albert, additional, Kapologwe, Ntuli, additional, Drake, Mary, additional, Zoungrana, Jeremie, additional, Troxel, Alena, additional, Lemwayi, Ruth, additional, Alidina, Shehnaz, additional, Maongezi, Sarah, additional, and Makuwani, Ahmad, additional

Published
2019
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14. Safety of Tubal Occlusion by Minilaparotomy Provided by Trained Clinical Officers Versus Assistant Medical Officers in Tanzania: A Randomized, Controlled, Noninferiority Trial

Author

Barone, Mark A., primary, Mbuguni, Zuhura, additional, Achola, Japhet Ominde, additional, Almeida, Annette, additional, Cordero, Carmela, additional, Kanama, Joseph, additional, Marquina, Adriana, additional, Muganyizi, Projestine, additional, Mwanga, Jamilla, additional, Ouma, Daniel, additional, Shannon, Caitlin, additional, and Tibyehabwa, Leopold, additional

Published
2018
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15. Additional file 1: of Safety of tubal ligation by minilaparotomy provided by clinical officers versus assistant medical officers: study protocol for a noninferiority randomized controlled trial in Tanzanian women

Author

Barone, Mark, Zuhura Mbuguni, Japhet Achola, Cordero, Carmela, Kanama, Joseph, Projestine Muganyizi, Jamilla Mwanga, Shannon, Caitlin, and Tibyehabwa, Leopold

Abstract

Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) checklist. (DOC 124Â kb)

Published
2017
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16. Safety of tubal ligation by minilaparotomy provided by clinical officers versus assistant medical officers: study protocol for a noninferiority randomized controlled trial in Tanzanian women

Author

Barone, Mark A., primary, Mbuguni, Zuhura, additional, Achola, Japhet Ominde, additional, Cordero, Carmela, additional, Kanama, Joseph, additional, Muganyizi, Projestine S., additional, Mwanga, Jamilla, additional, Shannon, Caitlin, additional, and Tibyehabwa, Leopold, additional

Published
2017
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