Lifebox in Moldova

Local leadership driving sustainable quality improvements


Moldova remains the poorest country in Europe.  Emerging from conflict and still under threat, it suffers resource and training shortfalls, making the provision of safe surgery a challenge. At the same time, anaesthesia and surgical teams are hungry for training, collaboration and research, and signs of improvement are increasingly clear.

Colleagues at the National Centre of Emergency Medicine worked with Lifebox associates to study the impact of oximetry and the Surgical Safety Checklist in a study coordinated by WHO. The resulting paper was published in the Annals of Surgery in 2013 and showed a clear reduction in complications, infection and hypoxic episodes.

The two-year follow up study came out in JAMA in 2015, marking “continued improvements in process measures and reductions in 30-day surgical complications almost 2 years after a structured implementation effort demonstrated marked, short-term reductions in harm.” Crucially, this resulted without continued oversight from the research team, “indicating the important role that local leadership and local champions play in the success of quality improvement initiatives, especially in resource-limited settings.”

Moldovan colleagues are making incredible strides towards a more conscious safety culture and safer surgery in general. The Checklist is undeniably taking root, led by some very thoughtful, dedicated and unsung champions on the ground in Chisinau and beyond. And Lifebox has been proud to support them with pulse oximeters for use in operating rooms recovery settings across government hospitals nationwide.

Moldova is really making progress in the field of patient safety and standards of care.

Dr Ruslan Baltaga