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Table 1 Safe surgery 2020 multi-modal mentorship intervention

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

 

In-person mentorship

Tele-mentoring (Project ECHO)

Smartphone App

(WhatsApp)

Description

On-site mentorship by multidisciplinary mentorship team to surgical team at each facility focusing on technical and non-technical skills

Telementoring sessions using a hub (mentors and international faculty) and spokes (surgical teams at 10 facilities in two regions). Open to all providers at facility

Regional WhatsApp groups including mentors and surgical teams at 5 facilities in the region

Frequency

2 days every 2 months

80-min weekly sessions

As needed over 24 h, 7 days a week

Focus

Mentorship on three tracks: clinical, data and patient pathway

Facilitation on development and implementation of the Quality Improvement Action Plan

Problem solving on perioperative and organizational challenges

Technical support on Facility Accelerator Fund priorities

Advocate on surgical priorities with facility and regional leaders

Didactic presentation on safe surgery topics

Presentation of a best practice or challenging case by one facility

Discussion and feedback on case by peers and mentors

Promotion and dissemination of clinical updates and recommendations

Communication by mentors, mentees, and safe surgery program team

Advice on management of patients

Sharing of monthly postsurgical infection rates and other program indicators by each facility

Sharing of successes and challenges

Examples of mentorship activities

Side-by-side mentoring on the Joel Cohen cesarean section technique to reduce postoperative complications

Coaching on the SSC in the OR by explaining why something is important and how to perform it effectively

Coaching on screening, classification and management of surgical site infections during ward rounds

Presentation and demonstration on standards for sterile processing of surgical instruments

Training sessions for hospital technicians and biomedical engineers covering various issues related to hospital equipment maintenance and repair

Presentation on how to manage four types of post-partum hemorrhage by mentors, followed by a case presentation by a surgical team and discussion by surgical providers and mentors

Mentee in a remote facility sends a message on a patient’s condition including photos and X-ray or lab results. Mentor provides guidance on patient management

Mentors share short video clip and photos demonstrating the B-Lynch procedure for the management of post-partum hemorrhage

Mentees submit monthly postsurgical infections rates. Mentors provide advice on strategies for improvement. Peers cheer or send encouraging messages