SQUAD in Uganda: Surgical Quality Assurance Database (A)
In 2011, Dr. Paul Firth, an anesthesiologist from Massachusetts General Hospital, began to explore methods for capturing and utilizing clinical data for quality improvement at Mbarara Regional Referral Hospital (MRRH) in Mbarara, Uganda. Partnering with Dr. Stephen Ttendo, head of the anesthesia department at MRRH, Firth obtained funding from the Harvard Milton Fund and from the General Electric Foundation in 2012 and established an electronic medical record database, now known as the SQUAD (Surgical Quality Assurance Database) initiative. Case A discusses the challenges of implementing an electronic medical record system in a public hospital where patient data had not previously been prioritized, and where resources for providing even basic care are limited. Case A explores the process of determining what to measure and how to measure and validate data.