Table 2 Summary of project objectives, proposed activities and reported achievements

Overarching project objective: To improve access to the operating theatres for both surgical and obstetric patients in Borodar, by increasing the number of procedures and decreasing delays and periods of closure

Audits to assess:

-Number of acute and elective procedures

-Delays for acute obstetric emergencies

-Amount of time ORs closed due to lack of functioning equipment or drugs

-None of the proposed audits were completed.

-6-week audit of cancellations completed but not seen by all partners/project team members

-No anecdotal evidence or reported observation of any improvement in through-put, delays or periods of closure

To meet objectives and carry out activites through on-going collaboration between Borodar and Glennworth partners

-Ongoing support and dialogue between partners via email

-One visit by Borodar OR committee members to UK

-Two visits by two Glennworth OR professionals to run training workshops and support the OR management committee

-Efforts to maintain dialogue between partners enacted, but significant challenges and misunderstandings reported

-Two visits by Borodar OR committee members to UK were undertaken, though later than scheduled

-One visit by Glennworth OR professionals to Borodar, though later than scheduled and training workshops not held.

To improve OR management through establishment of a functional, multi-disciplinary OR management team

-Identify and establish OR management team to include representatives of surgery, obstetrics, anaesthesia and nursing

-Hold regular, minuted meetings.

-OR management committee members identified

-Only two meetings held during 18-month project period

To train all OR professionals in OR leadership and management skills

-Run four two-day workshops on leadership and management for all qualified staff using the operating theatres and recovery (about 60).

-Proposed workshops on leadership and management not held

-Senior OR nurse provided some training in waste management to nurses

To establish clinical record keeping and clinical audit in the operating theatres as routine management tools, and to monitor patient intra-operative morbidity and mortality

-Establish a reporting system to monitor adverse incidents, peri-operative morbidity (including infection rates) and mortality.

-Establish a no-blame peri-operative morbidity and mortality review panel.

-Establish 6-monthly clinical audit meetings

-Create and use appropriate clinical records, including drug charts.

-At least 1 completed audit in each 6-month period by each of the 4 professional groups in operating theatres and recovery.

-Reporting system not established

-Morbidity and mortality review panel not established

-6-monthly clinical audit meetings not held

-New clinical records not created

-1 audit of cancelled procedures completed by one of the professional groups; no other audits reported to be completed by other groups for the project (although some Masters students working in the OR completed audits for course requirements, separate to the SCI initiative)