Quality Improvement Workgroup
US Lead: Alexis K. Nickols, MD, FACS
Lusaka Lead: Bright Moyo, BScHB, MBChB, MMed
The Quality Improvement (QI) Workgroup presented compelling evidence of progress during the April meeting, notably a 50% reduction in mortality in the pediatric burn unit following completion of a full QI cycle. This achievement, coupled with the success of the second QI Champions Training Workshop, signals important strides in patient safety and outcomes.
The group is concurrently tackling emergency department wait times and patient satisfaction improvements, though ongoing engagement with US partners remains challenging due to time zone differences. Despite these hurdles, the team remains focused on embedding QI principles within the clinical culture of the University Teaching Hospital (UTH) in Lusaka.
Looking ahead, the workgroup aims to modernize perioperative documentation by transitioning to REDCap-based digital records during the next 3 years, starting with operative notes and informed consent forms. Workgroup members are exploring AI-powered transcription tools that leverage audio and photo inputs to ease documentation workload.
Additionally, embedding QI education into registrar training through quarterly lectures led by QI champions is planned alongside monthly multidisciplinary QI meetings. Leadership engagement, particularly to support consistent documentation practices and informed consent adoption, will be essential to sustaining these advances and building a data-driven quality infrastructure at UTH.
Education Workgroup
US Lead: Laura Fischer, MD, FACS
Lusaka Lead: Victor Mapulanga, MD, MMed
The Education Workgroup reported meaningful progress in launching the ACS-UTH Simulation Lab, driven by significant investments of time, effort, and financial resources. Early educational programs are underway, yet the team acknowledged persistent challenges, including the absence of a dedicated on-site simulation champion, limited simulation supplies, unreliable internet access, and fragmented coordination across clinical and research teams. These obstacles have constrained broader educational expansion despite strong foundational work. The need for increased faculty and registrar engagement remains urgent, especially for didactic sessions, journal clubs, and mock oral exams.
To address these gaps, a strategic 3-year plan was outlined focusing on expanding the ACS-UTH Learning Center and developing structured curricula spanning faculty, registrars, and medical students. This plan includes introducing basic and advanced laparoscopic skills, group simulation scenarios incorporating anesthesia and nursing, and trauma training such as the TEAM course. Faculty development will be bolstered by surveys, workshops, and a proposed six-lecture annual series tailored to identified needs. Appointing simulation and didactic champions, establishing regular journal clubs, and strengthening regional partnerships are critical steps to solidify a sustainable, high-impact educational ecosystem.
Research Workgroup
US Lead: Muriel A. Cleary, MD, FACS
Lusaka Lead: Chihena Banda, MD, BScHB, MBChB, FCS(ECSA), PhD
The Research Workgroup showcased several key accomplishments, including a hands-on Biostatistics Workshop teaching R-based data analysis, and the launch of research-in-progress meetings with visiting faculty support. They also successfully established a $10,000 ACS H.O.P.E Research Fund for seed grants, with submissions due in summer 2025. The group additionally facilitated a manuscript writing workshop, combining lectures, real-time feedback, and collaborative editing to elevate manuscript quality and research dissemination.
Nevertheless, challenges persist, chiefly the absence of a hybrid research curriculum integrated with the MMED program, limited availability of faculty mentors, and difficulty synchronizing research activities with demanding clinical schedules. Isaac Fwemba, PhD, MPH, BSc, will lead curriculum development, supported by UTH and US faculty collaborations.
Strategic priorities include launching monthly hybrid sessions covering research methodologies, sustaining annual workshops on biostatistics, manuscript writing, grant writing, and providing structured mentorship for researchers at different project stages. During the next 3 years, the workgroup aims to increase academic output, broaden curricular reach to regional hubs, and enhance collaborative resources, including protected research time for registrars and faculty.
Clinical Care Workgroup
US Lead: John Kelly, MD, FACS
Lusaka Lead: Francis Pikiti, MD, MMed
Clinical Care Workgroup leaders have delineated key surgical specialties with co-leads appointed to strengthen communication and coordination. These specialties include vascular access and transplant, trauma/ACS education, pediatric surgery, minimally invasive surgery (MIS), endocrine, plastic, and orthopaedic surgery. A 12-month training rotation schedule is being developed to align available slots across partner institutions, ensure sufficient equipment and resource allocation, and improve anesthesia participation. The group prioritizes MIS, vascular access/transplant, pediatric surgery, and trauma education for year 1, emphasizing simulation-based learning while awaiting necessary equipment acquisitions.
The team also confronts challenges, including shortages of MIS and operative tools, OR and anesthesia staffing limitations, and funding reallocations after US Agency for International Development support withdrawal. Strengthening local clinical leadership with dedicated champions is viewed as critical for sustaining momentum. Plans for years 2 and 3 include monthly rotations, improved OR use aligned with UTH capacity, anesthesia cohorts accompanying US surgical teams, and launching a resident exchange program. Trauma training will expand through TEAM curriculum integration, with particular attention to multidisciplinary polytrauma care, further enhancing acute care surgery capacity at UTH.
Looking Ahead
ACS H.O.P.E. Lusaka is poised for continued growth by strengthening local leadership, expanding training programs, and advancing data-driven quality improvement. Technology integration and enhanced mentorship will empower clinicians and researchers to sustain progress.
Collaboration between UTH and US partners will address challenges like resource gaps and scheduling. Expanding simulation, research education, and clinical rotations, alongside faculty development, will improve patient care and academic output—laying the foundation for lasting surgical excellence in the region.
