Quality Improvement in Rural and Low-Resource Settings

Access to surgical care is a critical determinate of health outcomes yet disparities persist across various populations, particularly in low-resource settings (LRS). Quality improvement (QI) has become an integral component of health care optimization in such areas. The challenges of health care delivery in LRS directly translate into common barriers in QI endeavors such as the need for adequate funding, personnel trained in QI processes, and appropriate systems for consistent data collection. Many initiatives have been developed to address the multifaceted barriers in accessing surgical services and to improve patient safety and the quality of surgical care in LRS. Multiple studies have highlighted successful QI projects including implementing checklists to reduce surgical site infections, augmenting patient and staff education to reduce postoperative readmission rates, and adapting telemedicine in virtual intensive care units in rural areas. As new solutions, frameworks, and literature on QI initiatives expand, opportunities to enhance surgical care in LRS are becoming more apparent. This manuscript will review multiple aspects of QI including methods used in health care, barriers frequently encountered, challenges unique to LRS as well as projects implemented in LRS, with the goal of helping underserved health care settings learn and implement quality initiatives to improve the delivery of surgical care.