Other Titles
Rapid Presentation Round
Abstract
Access to safe surgical care significantly impacts morbidity, mortality, and quality of life. The 2015 Lancet Commission on Global Surgery emphasized integrating surgical and anesthesia services into national health systems to achieve global health goals. However, low- and middle-income countries (LMICs) face challenges, including a lack of data on operative care, limiting efforts to address disparities and develop effective policies.1
The Operative Encounter Registry (OER) was created to collect and analyze data on surgical, anesthesia, and nursing care, aiming to improve health outcomes, inform policy, and strengthen health systems in LMICs. The OER was developed under the guidance of the WHO Department for Integrated Health Services Clinical Services and Systems (CSY) Unit with technical support from the G4 Alliance OER Working Group. It was introduced at a children's hospital in Laos to track surgical and anesthetic outcomes for quality improvement. The project addressed the lack of reliable data in LMICs, focusing on mortality outcomes and quality improvement. Over four weeks, operating theater staff entered data prospectively.2
In the demonstration project, 75 patients were analyzed. The patient population was predominantly male (77%), with 38% under age 5. Trauma-related surgeries, particularly orthopedic injuries (37%), were the most common. Anesthesia care was provided exclusively by nurse anesthetists or trainees, with 34% of cases utilizing regional anesthesia. The WHO surgical safety checklist was used in 53 of 63 applicable cases, and all patients were stable upon transfer from the operating theater.
The findings show that the OER enables high-quality data collection and identifies areas for improvement in surgical and anesthesia care. By providing actionable data, the registry can support local and global policy development, enhance health system capacity, and improve patient outcomes. Additionally, this study reinforces the vital role of nurse anesthetists in expanding access to safe anesthesia in underserved regions like Laos, where provider shortages remain a significant barrier.
The introduction of the OER represents a promising step in addressing surgical and anesthesia care gaps in LMICs. By fostering global health collaboration and leveraging real-time data for quality improvement, this initiative offers a pathway to strengthen health systems and improve care delivery in resource-limited settings.
Notes
References:
1. Raymond P, Makasa E, Hollands M. World Health Assembly Resolution WHA68.15: Strengthening emergency and essential surgical care and anesthesia as a component of universal health coverage: addressing the public health gaps arising from lack of safe, affordable and accessible surgical and anesthetic services. World J Surg. 2015;39:2115-2125. doi:10.1007/s00268-015-3153-y
2. Aylin P, Bottle A, Majeed A. Use of administrative data or clinical databases as predictors of risk of death in hospital: comparison of models. BMJ. 2007;334(7602):1044. doi:10.1136/bmj.39168.496366.55
3. JotForm Inc. The easiest online form builder. Accessed February 14, 2023. https://www.jotform.com/about/
4. Kim JY. Opening address to the inaugural “The Lancet Commission on Global Surgery” meeting. The World Bank; January 17, 2014; Boston, MA, USA.
5. Meara JG, Leather AJM, Hagander L, et al. Global Surgery 2030: evidence and solutions for achieving health, welfare and economic development. Lancet. 2015;386:569-624. doi:10.1016/S0140-6736(15)60160-X
Sigma Membership
Eta
Type
Presentation
Format Type
Text-based Document
Study Design/Type
N/A
Research Approach
N/A
Keywords:
Trauma and Anesthesia Care, Operative Care, Disparities
Recommended Citation
Minahan, Chloé; Lee, Bounmi; Xiong, Vandee; Dodgion, Christopher; Sheneman, Natalie; Wetzig, Neil; Winokur, Robert; Chittaphai, Maly; and Henker, Richard, "Operative Encounter Registry by the G4 Alliance for Surgical, Obstetric, Trauma and Anesthesia Care" (2025). Creating Healthy Work Environments (CHWE). 101.
https://www.sigmarepository.org/chwe/2025/presentations_2025/101
Conference Name
Creating Healthy Work Environments
Conference Host
Sigma Theta Tau International
Conference Location
Phoenix, Arizona, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Operative Encounter Registry by the G4 Alliance for Surgical, Obstetric, Trauma and Anesthesia Care
Phoenix, Arizona, USA
Access to safe surgical care significantly impacts morbidity, mortality, and quality of life. The 2015 Lancet Commission on Global Surgery emphasized integrating surgical and anesthesia services into national health systems to achieve global health goals. However, low- and middle-income countries (LMICs) face challenges, including a lack of data on operative care, limiting efforts to address disparities and develop effective policies.1
The Operative Encounter Registry (OER) was created to collect and analyze data on surgical, anesthesia, and nursing care, aiming to improve health outcomes, inform policy, and strengthen health systems in LMICs. The OER was developed under the guidance of the WHO Department for Integrated Health Services Clinical Services and Systems (CSY) Unit with technical support from the G4 Alliance OER Working Group. It was introduced at a children's hospital in Laos to track surgical and anesthetic outcomes for quality improvement. The project addressed the lack of reliable data in LMICs, focusing on mortality outcomes and quality improvement. Over four weeks, operating theater staff entered data prospectively.2
In the demonstration project, 75 patients were analyzed. The patient population was predominantly male (77%), with 38% under age 5. Trauma-related surgeries, particularly orthopedic injuries (37%), were the most common. Anesthesia care was provided exclusively by nurse anesthetists or trainees, with 34% of cases utilizing regional anesthesia. The WHO surgical safety checklist was used in 53 of 63 applicable cases, and all patients were stable upon transfer from the operating theater.
The findings show that the OER enables high-quality data collection and identifies areas for improvement in surgical and anesthesia care. By providing actionable data, the registry can support local and global policy development, enhance health system capacity, and improve patient outcomes. Additionally, this study reinforces the vital role of nurse anesthetists in expanding access to safe anesthesia in underserved regions like Laos, where provider shortages remain a significant barrier.
The introduction of the OER represents a promising step in addressing surgical and anesthesia care gaps in LMICs. By fostering global health collaboration and leveraging real-time data for quality improvement, this initiative offers a pathway to strengthen health systems and improve care delivery in resource-limited settings.
Description
The Operative Encounter Registry (OER) was introduced in Laos to address gaps in surgical and anesthesia care through real-time data collection. Over four weeks, 75 patient cases highlighted the feasibility of collecting actionable data to improve outcomes. Nurse anesthetists played a critical role, with 34% of cases using regional anesthesia. This initiative demonstrates how the OER supports policy development and quality improvement, strengthening health systems in low-resource settings.