TY - JOUR T1 - Strategies for Improving Quality and Safety in Global Health: Lessons From Nontechnical Skills for Surgery Implementation in Rwanda JF - Global Health: Science and Practice JO - GLOB HEALTH SCI PRACT SP - 481 LP - 486 DO - 10.9745/GHSP-D-21-00042 VL - 9 IS - 3 AU - Daniel Josef Lindegger AU - Egide Abahuje AU - Kenneth Ruzindana AU - Elizabeth Mwachiro AU - Gilbert Rutayisire Karonkano AU - Wendy Williams AU - George Ntakiyiruta AU - Robert Riviello AU - Steven Yule AU - Simon Paterson-Brown Y1 - 2021/09/30 UR - http://www.ghspjournal.org/content/9/3/481.abstract N2 - Key MessagesEfforts to increase access to surgical care will achieve improved health outcomes only if those efforts are intertwined with efforts to increase surgical safety and quality.The World Health Organization Surgical Safety Checklist and Non-Technical Skills for Surgeons (NOTSS) framework are 2 tools to increase surgery quality and safety.The NOTSS for variable resource contexts is a new 1-day educational course developed in Rwanda that integrates contextually appropriate behaviors and values and can be implemented with low costs in any health care context.Program managers should provide context-specific NOTSS training for surgeons and operating theater staff.Policy makers should implement NOTSS framework into health care policy focusing on modern virtual teaching methods.Surgeons and operating theater staff should be familiar with the NOTSS framework and regularly update their knowledge through didactic courses, simulation, and online trainings.Résumé en français à la fin de l'article.In 2015 the Lancet Commission on Global Surgery published its report “Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development,”1 helping to galvanize a global movement to increase access to safe, timely, and affordable surgical and anesthesia care with an emphasis on equity. A goal of the movement is to enable the benefits of these efforts to be reaped most by impoverished and marginalized populations. The authors laid out 5 key messages, including the great number of operations required annually (approximately 143 million), especially among the poorest third of the world’s population, which receives only 6% of the operations. The commission called on nations to track and report on 6 metrics related to surgical care. Two of these metrics—surgeon, anesthetist, and obstetric (SAO) density (the number of specialist surgical, anesthetic, and obstetric providers per 100,000 population) and surgical volume (number of operations performed in operating rooms annually per 100,000 population)—are … ER -