Providing and Educating in Kigali, Rwanda with Team Heart: A goal for independent practice, Part 1

Allyson Lemay MD

Brigham and Women’s Anesthesiology

PGY4

Providing and Educating in Kigali, Rwanda with Team Heart: A goal for independent practice, Part 1

Operating Room at King Faisel Hospital

Operating room during one of the surgical procedures

When we arrived, the operating room was empty except for an anesthesia machine and OR table. We got to work setting up a functional cardiac OR and after many hours it was transformed into a usable space. Nurses, surgeons, anesthesiologists, and perfusionists were all working together to be able to provide complex medical care to patients with end stage rheumatic heart disease in a place where cardiac surgery is not performed. Not only was this difficult in itself, this trip also brings together providers from multiple institutions and different practice models and puts them in a high stress surgical situation. Communication was the key to success and implementing multiple safety check points us allowed to successfully provide safe, high-level care. For example, we used pre-operative, pre-incision, pre-bypass, and post-bypass checklists to make sure everyone in the operating room was on the same page and no assumptions were made. This also helped create a comfortable environment where everyone in the room was empowered to speak up and ask questions when they were unsure about a clinical situation. After a few days, it was an almost seamless operation and everyone was working well together to provide great care. It was truly amazing to see a group of people from different institutions with diverse practice models work together so well and this is one of the things I enjoyed most about the trip. It shows that patient-centric health care is not only the best for the patient but also fulfilling for the providers