5 Rs to Rescue Quality Improvement Program to Reduce Post-Surgery Deaths in Africa A Multi-Center Trial Across Ethiopia, South Africa, Tanzania, and Uganda

What this Trial Is About

Failure to rescue refers to preventable deaths after surgery due to delays in identifying and treating complications. This research aims to evaluate whether a quality improvement intervention called 5 Rs to Rescue can enhance monitoring and care for surgical patients in hospitals across four African countries Ethiopia, South Africa, Tanzania, and Uganda. The study uses a multi-center, cluster trial design with mixed methods to assess the interventions impact on reducing postoperative deaths. The 5 Rs to Rescue intervention focuses on five key areas assessing risk with the ASOS risk score, recognizing patient deterioration through regular vital signs and an Early Warning Score system, responding promptly using care pathways for common complications, reassessing patients after deterioration, and reflecting on care during regular meetings. This complex intervention is implemented in participating hospitals to improve patient surveillance after surgery. Participants are adults aged 18 and older who have surgery and receive postoperative care on study wards. Researchers will monitor the effectiveness of the intervention by reporting site-specific findings related to reducing in-hospital deaths within 72 hours after surgery. The study includes process evaluations and ongoing reflections to understand how the program works in practice. Participation involves routine monitoring and data collection during the postoperative period, with study completion expected by September 2026.

'5 Rs to Rescue' A Cluster Trial With an Embedded Process Evaluation