Clean Cut Fellow – Lifebox Foundation

POSITION DETAIL

Job Title: Clean Cut Fellow

Organization: Lifebox

About us: Global nonprofit making surgery and anesthesia safer worldwide.

Location: Rwanda with regular travel within Rwanda sites.

Reporting to: Global Clean Cut Clinical Lead

Key relationships: Lifebox’s program and clinical team; CC teams at selected facilities, UGHE program coordinator

Time commitment: 60% FTE (3 days per week)

Timeframe: One year contract (September 2023 – August2024)

ABOUT LIFEBOX

Lifebox is a global nonprofit founded to tackle the crisis of unsafe surgery. By investing in tools, training, and partnerships, we address critical gaps in surgical systems to make surgery and anesthesia safer worldwide. Lifebox’s work focuses on three core areas: anesthesia safety, surgical teamwork, and reducing surgical infection. Since 2011, Lifebox has worked in over 116 countries, trained more than 12,000 healthcare providers, and made 181 million surgeries safer. www.lifebox.org

ABOUT CLEAN CUT PROGRAM

Surgical site infections (SSI) represent a major cause of postoperative morbidity and mortality particularly in low and middle-income countries (LMICs). The World Health Organization (WHO) Safe Surgery Checklist has been shown to substantially reduce perioperative complications and mortality in many settings, including LMICs. Many of the items on the WHO Checklist are related to reducing risk of infection; Lifebox aims to improve adherence to these measures to reduce postoperative infectious complications in LMICs through its Clean Cut (CC) program.

Lifebox’s Clean Cut program is a 6-9 month surgical infection prevention quality improvement (QI) program that reduced the relative risk of SSI by 35% at five hospitals pilot sites in Ethiopia between 2016-2018. Since then, Lifebox has expanded Clean Cut to 26 hospitals across 5 countries.

The program aims to reduce infectious complications from surgery by improving adherence to evidence-based perioperative standards. The standards present in the WHO Safe Surgery Checklist include appropriate administration of antibiotics, proper gauze counting, and confirmation of instrument and gown/drape sterility; other components of Clean Cut address appropriate hand and skin decontamination, use of sterile gloves, gowns and drapes, and routine use of the checklist to promote communication in the operating theater.

The program works sequentially by 1) engaging a multidisciplinary team, 2) mapping out current processes at each hospital, and 3) identifying gaps and opportunities for improvement, and generating locally derived solutions at the hospital level. Throughout this iterative process, data are collected on intraoperative adherence to the standards, as well as subsequent patient outcomes.

Currently adapted versions of Clean cut (Clean Cut for C-section, Clean Cut for Cleft and Clean Cut for Long bone fracture) are implemented as research in selected facilities.

Lifebox in collaboration with UGHE & CRI foundation is planning to implement the Clean Cut program at four facilities in Rwanda (University Teaching Hospital of Butare, Kirehe Hospital, Kabgayi Hospital and Kibogora Hospital) over a period of two years. The sites for the first year will be University Teaching Hospital of Butare and Kabgayi Hospital.

PURPOSE OF THE ROLE

The Clean Cut Fellow will be responsible for providing clinical support and following the implementation of Clean Cut at the selected hospitals ensuring successful implementation of the program. He/ She will closely work with hospital teams, Lifebox’s program and clinical team and UGHE program coordinator.

ROLES AND RESPONSIBILITIES

The specific roles and responsibilities include, but are not limited to:

• Play a role in the formation of the Clean Cut team at each Clean Cut implementing hospitals.
• Reviewing and understanding of the Clean Cut methodology and content.
• Reviewing and aligning/ customizing data collection tools and training materials as needed.
• Monitor the overall Clean Cut implementation process by the hospital team.
• Work closely with the hospital Clean Cut leads in implementing the activities outlined on the work plan.
• Conducting training to hospital teams and helping identify TOTers who can expand the program going forward.
• Following closely data collection and taking the lead in assuring data quality by conducting regular data quality checks in collaboration with Lifebox’s M&E manager and hospital leads. And address any data-related issues on DHIS2 and consult with the DHIS2 consultant for timely action.
• Leading monthly Clean Cut adherence meetings and helping create an engaged surgical community which includes surgeons, anesthesia providers, nurses and other stakeholders.
• Lead the process of data analysis and assessing the overall effectiveness and impact of the project.
• Prepare, submit and/or present activity plans and reports monthly.
• Preparation, submission and presentation of Lifebox/ CRI/ UGHE -related research or quality improvement works.
• Take the initiative of doing a separate research activity with the support of the Lifebox team. The timeline should be aligned with the duration of the fellowship. The concept note and proposal development should be made with the support of the Lifebox team.
• Prepare, submit and/or present the overall fellowship report at the end of the fellowship program.
• Take part in the clinical team meeting and other Lifebox team meetings.
• Work smoothly with the program manager as well as the Clean Cut clinical lead.

PERSON SPECIFICATION

Essential

• Graduate in either nursing, surgery or anesthesia.
• A minimum of two years experience of working in the operating room as part of the surgical team.
• Currently working at a facility in Rwanda.
• Commitment for the duration of the fellowship.
• Able to dedicate three days per week for fellowship related activities.
• Excellent communication and interpersonal skills.
• Excellent computer literacy, with proficiency in Google Drive, data analysis software and online communication tools.
• Ability to manage a complex and dynamic workload with competing priorities within tight deadlines.
• Proven ability to work independently and as part of a team.

Desirable

• Previous experience participating in research.

ACCOUNTABILITY

Direct accountability is to the Global Clean Cut Clinical Lead but will closely work with the Head of Programs for East and Southern Africa, program manager, M&E personnel, as well as UGHE program coordinator.

TIME COMMITMENT

This is a part-time role with an estimated time commitment of 3 days per week.

Minimum one year commitment, with potential for further extension.