ADVANCING TRAUMA SYSTEM PERFORMANCE IN ETHIOPIA THROUGH TEAM-BASED TRAUMA QUALITY IMPROVEMENT TRAINING: RESPONSE TO AN INAUGURAL TRAINING INITIATIVE dabuaqel@mcw.edu

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ADVANCING TRAUMA SYSTEM PERFORMANCE IN ETHIOPIA THROUGH TEAM-BASED TRAUMA QUALITY IMPROVEMENT TRAINING: RESPONSE TO AN INAUGURAL TRAINING INITIATIVE

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Noor Bhatti nbhatti@mcw.edu Medical College of Wisconsin Department of Surgery Milwaukee United States

Rachel Koch Rachel.Koch@ucsf.edu University of California San Francisco Department of Surgery San Francisco United States

 

 

United States

Oral or Poster

Trauma is the leading cause of preventable morbidity and mortality in Ethiopia, yet trauma-specific quality improvement (QI) infrastructure remains limited. To address this gap, a multidisciplinary trauma QI course was implemented in June 2025 at ALERT and AaBET Hospitals with support from the Ministry of Health, Ethiopia. The training aimed to establish trauma QI committees and build capacity in systems thinking, error analysis, and process improvement.

Participants from six cadres, including nurses, general practitioners, and surgeons, completed pre- and post-course surveys assessing five QI domains. Responses were analyzed using unpaired t-tests and Wilcoxon rank-sum tests. Post-course evaluations were assessed descriptively.

Twenty-six participants (84%) completed the pre-course survey, and 14 (45%) completed the post-course survey. Significant improvements were observed in understanding the QI process (mean pre = 4.0, post = 5.0, p = 0.002) and confidence in preventing repeat errors (mean pre = 4.0, post = 5.0, p = 0.040). The largest domain-level gains were in blame culture (+0.55) and systems thinking (+0.40), with more modest increases in self-efficacy (+0.28) and leadership (+0.02), and a slight decline in QI value (–0.18) (Figure 1). Trust in institutional error handling remained low (median = 3.0). General practitioners and unit coordinators showed the most consistent gains; nurses demonstrated greater variability, including the only decline in perceived QI value.

The course enhanced QI knowledge and confidence, but also highlighted persistent institutional barriers. Sustained progress will require leadership engagement, integration into existing QI structures, and resource-sensitive strategies for scale-up.