The Anaesthesia Launchpad: A Simulation-based Framework To Enhance Perioperative Safety In Rural District Hospitals

Background: Delivering safe anaesthesia in rural district hospitals remains a challenge due to limited resources, staff shortages, and variable provider experience. The Anaesthesia Launchpad was developed as a two-day, interactive, simulation-based workshop designed to build anaesthesia capacity at district hospitals. The initiative aims to enhance skills, strengthen professional networks, and improve referral pathways to tertiary centers. This study evaluates the impact of the program and its potential for sustainability. Methods: The Anaesthesia Launchpad was implemented in multiple district hospitals across the Eastern Cape, South Africa, in 2022 - 2024. Training included hands-on simulations, case-based discussions, and structured learning around a five-step framework: (1) Pause (2) Prepare (3) Do the Basics Right, (4) Expect and Manage Common and Severe Complications, (5) Value the Recovery Time. The program expanded through faculty development workshops and a growing network of trained healthcare providers. Data was collected through pre- and post-course assessments and participant feedback surveys. Results: Since its inception, 37 doctors from 17 district hospitals have completed the program, with a marked improvement in knowledge, confidence, and adherence to perioperative safety principles. Participants reported stronger professional relationships with referral institutions and improved communication between district hospitals. Faculty expansion efforts trained 11 new instructors to support sustainability and regional scale-up. However, challenges such as persistent resource constraints and the need for continuous training were identified. Conclusion: The Anaesthesia Launchpad has demonstrated success in improving anaesthesia safety and strengthening surgical systems at district hospitals. To maximize its impact, further integration with outreach, in-situ training, and quality improvement initiatives is needed. Future plans include expanding the program within South Africa and piloting an international adaptation in Namibia.