African Journal of Public Health and Health Systems | 07 September 2007
Action Research on the Impact of a Surgical Safety Checklist on Theatre Output and Waiting Times in Kayes Region, Mali
F, a, t, o, u, m, a, t, a, K, o, n, a, t, é
Abstract
Long surgical waiting times and limited theatre output are significant challenges for district hospitals in low-resource settings. In the Kayes Region of Mali, these constraints contribute to delayed care. The surgical safety checklist is established for improving patient safety, but its effect on operational efficiency in such contexts is not well documented. This action research study assessed the impact of introducing a contextually adapted surgical safety checklist on surgical theatre output and patient waiting times in district hospitals within the Kayes Region. A participatory action research approach was used in three district hospitals. Baseline data on monthly surgical case volume and average waiting time for elective surgery were collected. A surgical safety checklist was then co-developed with local theatre teams and implemented. Post-implementation data were collected and compared to baseline. Staff perceptions were explored through focus group discussions. Following checklist implementation, the average monthly surgical output increased by approximately 18% across the three sites. The median waiting time for elective procedures decreased from an estimated 16 weeks to 12 weeks. Qualitative findings indicated that improved team communication and procedural standardisation were key facilitators of the efficiency gains. The introduction of a co-developed surgical safety checklist was associated with improved theatre output and reduced waiting times in these Malian district hospitals. The checklist functioned as both a safety tool and a catalyst for better operative team coordination and workflow. Health authorities in similar resource-constrained settings should consider supporting the contextual adaptation and implementation of the surgical safety checklist to improve surgical system efficiency. Sustained focus on team training and checklist adherence is necessary. Surgical safety checklist, waiting times, theatre output, action research, district hospitals, Mali, global surgery This study provides empirical evidence from a low-resource setting that a contextually adapted surgical safety checklist can contribute to improvements in both surgical safety and operational efficiency.