Dr. Maia Nofal is a general surgery resident at Boston Medical Center and a post-doctoral NIH-Fogarty Fellow in the Global Health Equity Scholars program at Stanford. Her research interests focus on improving peri-operative surgical care in low-resource settings. She works primarily on adapting implementation and evaluation of the Clean Cut program, a surgical quality improvement program run by Lifebox to reduce surgical site infections through strengthening systems of infection prevention and control. More recently, her work has focused on antibiotic prescribing practices, resistance patterns, and antibiotic stewardship systems at partner hospitals Ethiopia where she is developing quality improvement initiatives to promote evidence-based prescribing practices.
Boards, Advisory Committees, Professional Organizations
Global Health Postdoctoral Affiliate, Center for Innovation in Global Health (CIGH) (2023 - Present)
Doctor of Medicine, Boston University (2020)
Master of Public Health, Boston University (2016)
Bachelor of Science, University of California Davis (2014)
Addressing knowledge gaps in Surgical Safety Checklist use: statistical process control analysis of a surgical quality improvement programme in Ethiopia.
The British journal of surgery
BACKGROUND: The WHO Surgical Safety Checklist reduces morbidity and mortality after surgery, but uptake remains challenging. In particular, low-income countries have been found to have lower rates of checklist use compared with high-income countries. The aim of this study was to determine the impact of educational workshops on Surgical Safety Checklist use implemented as part of a quality improvement initiative in five hospitals in Ethiopia that had variable experience with the Surgical Safety Checklist.METHODS: From April 2019 to September 2020, each hospital implemented a 6-month surgical quality improvement programme, which included a Surgical Safety Checklist workshop. Statistical process control methodology was used to understand the variation in Surgical Safety Checklist compliance before and after workshops and a time-series analysis was performed using population-averaged generalized estimating equation Poisson regression. Checklist compliance was defined as correctly completing a sign in, timeout, and sign out. Incidence rate ratios of correct checklist use pre- and post-intervention were calculated and the change in mean weekly compliance was predicted.RESULTS: Checklist compliance data were obtained from 2767 operations (1940 (70 per cent) pre-intervention and 827 (30 per cent) post-intervention). Mean weekly checklist compliance improved from 27.3 to 41.2 per cent (mean difference 13.9 per cent, P = 0.001; incidence rate ratio 1.51, P = 0.001). Hospitals with higher checklist compliance at baseline had the greatest overall improvements in compliance, more than 50 per cent over pre-intervention, while low-performing hospitals showed no improvement.CONCLUSION: Surgical Safety Checklist workshops improved checklist compliance in hospitals with some experience with its use. Workshops had little effect in hospitals unfamiliar with the Surgical Safety Checklist, emphasizing the importance of multifactorial interventions and culture-change approaches. In receptive facilities, short workshops can accelerate behaviour change.
View details for DOI 10.1093/bjs/znad234
View details for PubMedID 37551706
- Sustainability of a Surgical Quality Improvement Program at Hospitals in Ethiopia. JAMA surgery 2021