University of California San Francisco

Nichole Starr, MD, MPH

Nicole Starr Headshot 2025
Nichole Starr, MD, MPH

Assistant Professor of Surgery
Division of General Surgery
Trauma and Surgical Critical Care
Zuckerberg San Francisco General Hospital

[email protected]

Biography

Dr. Nichole Starr is a trauma and critical care surgeon dedicated to advancing equitable surgical and trauma care globally through innovation, quality improvement, and sustainable partnerships. Her research spans infection prevention, trauma systems strengthening, and perioperative safety, with a particular focus on Ethiopia and other low-income environments.

She co-developed and scaled the Clean Cut surgical infection prevention program, an adaptive WHO checklist-based quality improvement intervention. Clean Cut has been implemented in more than 40 hospitals across 10 countries and recently demonstrated sustainability and scalability in JAMA Surgery (2022, 2023, 2025). This work has informed hospital practice change, national health policy, and global discourse on patient safety in surgery.

In trauma care, Dr. Starr collaborated with the Ethiopian Federal Ministry of Health and WHO to establish national trauma registries at multiple hospitals and create local trauma quality improvement committees. These initiatives are enabling evidence-driven prevention of injury-related deaths and have led to multiple peer-reviewed publications, including the first large trauma registry analysis from Addis Ababa.

Beyond research, Dr. Starr is deeply committed to mentorship, having supported students and residents across the U.S., Ethiopia, and multiple LMICs in global health research and careers. She co-founded Socially Responsible Surgery at UCSF, embedding equity as a core principle in surgical training and practice.

Education

Institution Degree Dept or School End Date
UCSF Trauma & Acute Care Surgery Fellowship Trauma & Acute Care Surgery 09/2025
UCSF Surgical Critical Care Fellowship Surgical Critical Care 08/2024
UCSF General Surgery Residency General Surgery 06/2023
Boston University School of Medicine MD Medicine 05/2015
Boston University School of Public Health MPH Public Health 05/2008
University of Miami BS Neuroscience 05/2006
University of Miami BA Theatre Arts 05/2006

Awards & Honors

Award Conferred By Date
ACS/Pfizer Resident Surgical Volunteerism Award American College of Surgeons HOPE/Pfizer 2024
Dr. Hilary Sanfey Outstanding Resident Award Association of Women Surgeons 2023
Evan C. Werlin Lodestar Award UCSF Department of Surgery 2023
Haile T. Debas Resident Teaching Award UCSF Department of Surgery 2023
Medical Student Teaching Award UCSF Department of Surgery 2023
William B. Schecter Trauma Resident Award UCSF 2022
Muriel Steele Society Influential Women in Surgery Honor Roll UCSF 2019/2022
Surgical Infections Society Best Oral Presentation, Second Place Surgical Infection Society 2019
Junior Resident Teaching Award UCSF 2018
Department of Emergency Medicine Surgical Consultant of the Year UCSF 2017
Dora Savenor Memorial Prize for Excellence in Surgery Boston University School of Medicine 2015
The Leonard Tow Humanism in Medicine Student Award Boston University School of Medicine 2015

Grants and Funding

  • Global Health Equity Scholars Program - D43 Fogarty Training | NIH | 2017-07-01 - 2022-06-30 | Role: Co-Investigator
  • Research Training in Gastrointestinal Surgery | NIH | 1988-07-01 - 2021-06-30 | Role: Co-Investigator

Research Interests

Cost-Effectiveness Analyses of Surgical Organizations

Barriers to Accessing Surgical Care

Trauma Care

Research Pathways

Global Surgery & Public Health

Publications

MOST RECENT PUBLICATIONS FROM A TOTAL OF 50
  1. Global Scaling of a Surgical Infection Prevention Program to 5 Low-Resource Countries.
    Writing Group for the Clean Cut Investigators Group, Nofal MR, Tesfaye A, Gebeyehu N, Starr N, Arimino S, Chaula D, Harrell-Shreckengost C, Utam T, Ambulkar R, Rocabado K, Taye Haile S, Mammo TN, Weiser TG| | PubMed
  2. Factors associated with successful implementation of Clean Cut: a perioperative surgical site infection prevention quality improvement programme-a cohort study of low-resource hospitals.
    Nofal MR, Gebeyehu N, Starr N, Tesfaye A, Arimino S, Haile ST, Mammo TN, Weiser TG| | PubMed
  3. Impact of WHO's Surgical Safety Checklist-Based Program on Cleft-lip and Palate Repair Outcomes in LMICs-The CLEAN CLEFT Program.
    Alamnie G, Timo M, Arimino S, Eshete M, Gebreegziabher A, Abate F, Kebede H, Mehendale F, Ehua-Koua M, Moulot O, Bankole R, Starr N, Mammo TN| | PubMed
  4. Injury and violence in the context of sustainable development: The first Bethune Round Table in Africa, Bethune Round Table 2024, Conference on Global Surgery, May 16-18, 2024, Addis Ababa, Ethiopia.
    Lett R, Bartolomeos K, Lett R, Laeke T, Tirsit A, Kassahun A, Boniface R, Munthali V, Razek T, Deckelbaum D, Bracco D, Presser E, Belay E, Kifle F, Weiser TG, Iverson K, Takoutsing BD, Dalle DU, Mbangtang CB, Nyalundja AD, Macaraeg J, Dzirasa I, Kanmounye US, Dovlo D, Koram K, Nyarko E, Jumbam DT, Shimber ET, Jaraczewski T, Sgro M, Basmayor AM, Ergete A, Iverson K, Schroeder M, Dodgion C, Gyedu A, Nakua E, Donkor P, Mock C, Awedew A, Laeke T, Yibeltal M, Ayele M, Melkamu H, Bekele S, Hailemariam B, Shiferaw E, Shiferaw Y, Yirdaw W, Sawhney R, Patel S, Basak D, Veetil DK, Roy N, Wärnberg MG, Rath S, Abdullahi MAS, Mbaya K, Kakasanda A, Danjuma S, Olasoji H, Ameh E, Bedada A, Motsumi MJ, Hamda SG, Ibro S, Amdisa D, Tilahun G, Abeza M, Laeke T, Boroditsky M, Hill M, Hilzenrat R, Livergant R, Adams J, Binda C, Chhor A, Hsiao H, Haji F, Chin E, Oyania F, Stephens CQ, Ullrich S, Kotagal M, Bajunirwe F, Ozgediz DE, Poenaru D, Kravarioti D, Wong LY, Teklemariam TL, Tirsit A, Liyew T, Ferguson M, Plackett T, Henry JC, Dodgion C, Abeza MA, Minas SM, Bouchard M, Tennakoon D, Sawhney R, Burra R, Mathew F, Jones A, Virk S, Patel S, Vaghaiwalla T, Hudspeth J, Rabin T, Rowthorn V, Price RR, Raykar N, Eamer G, Mutiso S, Kisaka Y, Gathecha G, Lett R, Onu C, Ameh E, Igoche M, Anyanwu P, Onuh E, Ojeamen O, Yawe ET, Abubakar A, Ashoms Y, Suleiman H, Musa N, Kyengera DK, Abebe N, Gardener R, Berhanu D, Abebe NS, Zeleke HT, Sawhney R, Proulx KR, Gerk A, Guadagno E, Poenaru D, Kundu S, Laor B, Sawhney R, Wurdeman T, Botelho F, Gerk A, Guadagno E, Poenaru D, Ayele M, Kassahun A, Laeke T, Yibeltal M, Hailu B, Fikru E, Ibro SA, Workineh A, Balcha F, Abamecha F, Shemsi S, Alruwaili AS, Rodriguez G, Jose A, Ebied S, Girma S, Abiy A, Assen HE, Tesfaye K, Demeke K, Yiheyis A, Jemal K, Yilkal D, Amsalu A, Derseh L, W/Gerima Y, Belayneh T, Tiruneh M, Bitew A, Yitayih S, Awoke T, Worku C, Mohammed A, Alemu M, Yesuf M, Mamo F, Shitu K, Liyew B, Gucho A, Tilahun G, Love T, Chew A, Kasagga B, Takoutsing B, Ekwaro O, Elobu E, Mengistu DD, Zhuang A, Shiferew B, Mengistu G, Zewdie A, Tadelle N, Gebreyesus A, Presser E, Iverson K, Dodgion C, Weiser TG, Koch R, Starr N, Lau D, Zivkovic I, Joharifard S, Joos E, Garraway N, Vituci F, O'Flynn E, Péric I, Simon L, Ibbotson G, Seyoum T, Azazh A, Beza L, Onah I, Chukwuma C, Berhanu D, Shenoi J, Sears N, Bedore Y, Caplan R, Shale WT| | PubMed
  5. Needs Assessment for the Development of a Sustainability Curriculum for Surgical Residents.
    Matthys M, Wang J, Sathe TS, Wang K, Gandhi S, Lee H, Alseidi A, Sustainability Curriculum Working Group| | PubMed
  6. A Perioperative Quality Improvement Program for Cesarean Delivery in Ethiopia: A Stepped-Wedge Cluster Randomized Clinical Trial.
    Mammo TN, Feyssa MD, Nofal MR, Gebeyehu N, Shiferaw MA, Tesfaye A, Fikre T, Woldeamanuel H, Alemu SB, Miller K, Haile ST, Weiser TG, Checklist Expansion for Antisepsis and Infection Control in Cesarean Section (CLEAN-CS) Trial Group| | PubMed
  7. A Prospective Quality Improvement Program to Reduce Prolonged Postoperative Antibiotic Prophylaxis in Ethiopia.
    Nofal MR, Tesfaye A, Gebeyehu N, Masersha MN, Hayredin I, Belayneh K, Getahun B, Starr N, Abebe K, Sebsebe Y, Alemu SB, Mammo TN, Weiser TG| | PubMed
  8. A novel global safe surgery mentorship program using a multidisciplinary team approach.
    Negash S, Starr N, Mesfin S, G Weiser T, Negussie TM| | PubMed
  9. Review of a large trauma registry in Addis Ababa, Ethiopia: insights into prehospital care and provider training for trauma quality improvement.
    Starr N, Ayehu M, Zhuang A, Minalu HT, Alemu GK, Fisseha S, Chekol S, Habtemariam A, Hadis M, Alemtsehay B, Mengiste M, Kefeni Bori A| | PubMed
  10. Prehospital balanced resuscitation may mitigate hypofibrinogenemia in traumatic hemorrhagic shock.
    Starr N, Kornblith L| | PubMed
  11. The Devil's in the Depot Details: Case of Iatrogenic Opioid Intoxication After Buprenorphine Injection Requiring Surgical Excision.
    Vais S, Starr N, Castro M, Brand N, Murphy A, Tesoriero R, Kryzhanovskaya I| | PubMed
  12. Scalability and Sustainability of a Surgical Infection Prevention Program in Low-Income Environments.
    Starr N, Gebeyehu N, Nofal MR, Forrester JA, Tesfaye A, Mammo TN, Weiser TG, Lifebox Clean Cut Collaborative, Amdie DA, Abreha M, Alemu M, Ally S, Abdukadir AA, Assefa G, Bedore Y, Bekele A, Berhanu M, Alemu SB, Chimdesa Z, Derbew M, Fast C, Fernandez K, Kahsay S, Kassahun A, Kebede H, Kitesa G, Koritsanszky L, Lima B, Mellese B, Mengistu M, Negash S, Tara M, Taye S, Torgeson K, Tsehaye M, Tiruneh A, Stave K| | PubMed
  13. An observational cohort study on the effects of extended postoperative antibiotic prophylaxis on surgical-site infections in low- and middle-income countries.
    Clean Cut Investigators Group| | PubMed
  14. Addressing knowledge gaps in Surgical Safety Checklist use: statistical process control analysis of a surgical quality improvement programme in Ethiopia.
    Nofal MR, Starr N, Negussie Mammo T, Trickey AW, Gebeyehu N, Koritsanszky L, Alemu M, Tara M, Alemu SB, Evans F, Kahsay S, Weiser TG| | PubMed
  15. Feasibility of Gastrografin Use for Adhesive Small Bowel Obstruction in Low-Income Countries.
    Starr N, Tadesse M, Igwebuike C, Sherefa K, Genetu A, Aregawi Y, Zewdu E, Tamirat D, Desalegn M, Getahun B, Harris H, Zemenfes D| | PubMed
  16. Correction: Academic global surgical competencies: A modified Delphi consensus study.
    Pawlak N, Dart C, Aguilar HS, Ameh E, Bekele A, Jimenez MF, Lakhoo K, Ozgediz D, Roy N, Terfera G, Ademuyiwa AO, Alayande BT, Alonso N, Anderson GA, Anyanwu SNC, Aregawi AB, Bandyopadhyay S, Banu T, Bedada AG, Belachew AG, Botelho F, Bua E, Campos LN, Dodgion C, Drejza M, Durieux ME, Dutta R, Erdene S, Vaz Ferreira R, Gathuya Z, Ghosh D, Jawa RS, Johnson WD, Khan FA, Navas Leon FJ, Long KL, Macleod JBA, Mahajan A, Maine RG, Malolos GZC, McClain CD, Nabukenya MT, Nthumba PM, Nwomeh BC, Ojuka DK, Penny N, Quiodettis MA, Rickard J, Roa L, Salgado LS, Samad L, Seyi-Olajide JO, Smith M, Starr N, Stewart RJ, Tarpley JL, Trostchansky JL, Trostchansky I, Weiser TG, Wobenjo A, Wollner E, Jayaraman S| | PubMed
  17. Academic global surgical competencies: A modified Delphi consensus study.
    Pawlak N, Dart C, Aguilar HS, Ameh E, Bekele A, Jimenez MF, Lakhoo K, Ozgediz D, Roy N, Terfera G, Ademuyiwa AO, Alayande BT, Alonso N, Anderson GA, Anyanwu SNC, Aregawi AB, Bandyopadhyay S, Banu T, Bedada AG, Belachew AG, Botelho F, Bua E, Campos LN, Dodgion C, Drejza M, Durieux ME, Dutta R, Erdene S, Ferreira RV, Gathuya Z, Ghosh D, Jawa RS, Johnson WD, Khan FA, Leon FJN, Long KL, Macleod JBA, Mahajan A, Maine RG, Malolos GZC, McClain CD, Nabukenya MT, Nthumba PM, Nwomeh BC, Ojuka DK, Penny N, Quiodettis MA, Rickard J, Roa L, Salgado LS, Samad L, Seyi-Olajide JO, Smith M, Starr N, Stewart RJ, Tarpley JL, Trostchansky JL, Trostchansky I, Weiser TG, Wobenjo A, Wollner E, Jayaraman S| | PubMed
  18. Correction: Exploring the Use of a Fit-for-Purpose Surgical Headlight in Sub-Saharan Africa: Mixed Methods Study.
    Hussien M, Capo-Chichi N, Starr N, Johansen E, Negash S, Utam T, Negussie T, Fernandez K, Weiser TG| | PubMed
  19. Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries.
    National Institute for Health and Care Research Global Health Research Unit on Global Surgery| | PubMed
  20. Exploring the Use of a Fit-for-Purpose Surgical Headlight in Sub-Saharan Africa: Mixed Methods Study.
    Hussien M, Capo-Chichi N, Starr N, Johansen E, Negash S, Utam T, Negussie T, Fernandez K, Weiser TG| | PubMed
  21. Bridging the know-do gap in low-income surgical environments: Creating contextually appropriate training videos to promote safer surgery in Ethiopia.
    Hawkins J, Rangel UJS, Tesfaye A, Gebeyehu N, Weiser TG, Bitew S, Mammo TN, Starr N| | PubMed
  22. Evaluation of an adaptive, multimodal intervention to reduce postoperative infections following cesarean delivery in Ethiopia: study protocol of the CLEAN-CS cluster-randomized stepped wedge interventional trial.
    Mammo TN, Feyssa MD, Haile ST, Fikre T, Shiferaw MA, Woldeamanuel H, Temesgen F, Gebeyehu N, Starr N, Fernandez K, Henrich N, Alemu SB, Miller K, Weiser TG| | PubMed
  23. Platelet Transfusion for Trauma Resuscitation
    Nichole Starr, Zachary Matthay, Alexander Fields, Matthew D. Neal & Lucy Zumwinkle Kornblith| | UCSF Research Profile
  24. Perioperative provider safety in the pandemic: Development, implementation and evaluation of an adjunct COVID-19 Surgical Patient Checklist.
    Starr NE, Moore JN, Shreckengost CSH, Fernandez K, Ambulkar RP, Capo-Chichi N, Varallo JE, Ademuyiwa AO, Krouch S, Rana PS, Ingabire JA, Weiser TG, Mammo TN, Evans FM| | PubMed
  25. Perioperative health care provider safety and resource availability during the COVID-19 pandemic in India and other low middle-income countries.
    Ambulkar R, Rana PS, Starr N, Moore J| | PubMed
  26. Global Collaboration on a UV-C Cabinet to Decontaminate and Reuse N95 Respirators in Low- and Middle-Income Environments
    Nichole Starr, MD, MPH, Natnael Gebeyehu, MD, Anderson S. L. Gomes, PhD, E. Rosas, PhD, Tyler N. Chen, MS, Dawit Assefa, PhD, Jared Shless, Jit Bhattacharya, PhD, Arnab Bhattacharya, PhD, David Robinowitz, MD, MHS, MS, Martin Purschke, PhD, and Thomas Baer, PhD| | UCSF Research Profile
  27. Clean and Confident: Impact of Sterile Instrument Processing Workshops on Knowledge and Confidence in Five Low- and Middle-Income Countries.
    Harrell Shreckengost CS, Starr N, Negussie Mammo T, Gebeyehu N, Tesfaye Y, Belayneh K, Tara M, Lima I, Jenkin K, Fast C, Weiser TG| | PubMed
  28. Operating room efficiency in a low resource setting: a pilot study from a large tertiary referral center in Ethiopia.
    Negash S, Anberber E, Ayele B, Ashebir Z, Abate A, Bitew S, Derbew M, Weiser TG, Starr N, Mammo TN| | PubMed
  29. Sustainability of a Surgical Quality Improvement Program at Hospitals in Ethiopia.
    Starr N, Nofal MR, Gebeyehu N, Forrester JA, Derbew M, Weiser TG, Mammo TN| | PubMed
  30. Comment on "COVID-19 Preparedness Within the Surgical, Obstetric, and Anesthetic Ecosystem in Sub Saharan Africa".
    Starr N, Weiser TG| | PubMed
  31. Perioperative Provider Safety in Low- and Middle-income Countries During the COVID-19 Pandemic: A Call for Renewed Investments in Resources and Training.
    Starr N, Capo-Chichi N, Moore J, Shreckengost CH, Fernandez K, Ambulkar R, Varallo JE, Ademuyiwa AO, Krouch S, Rana PS, Ingabire JA, Weiser TG, Mammo TN, Evans FM| | PubMed
  32. Academic Global Surgery Curricula: Current Status and a Call for a More Equitable Approach.
    Jayaram A, Pawlak N, Kahanu A, Fallah P, Chung H, Valencia-Rojas N, Rodas EB, Abbaslou A, Alseidi A, Ameh EA, Bekele A, Casey K, Chu K, Dempsey R, Dodgion C, Jawa R, Jimenez MF, Johnson W, Krishnaswami S, Kwakye G, Lane R, Lakhoo K, Long K, Madani K, Nwariaku F, Nwomeh B, Price R, Roser S, Rees AB, Roy N, Ruzgar NM, Sacoto H, Sifri Z, Starr N, Swaroop M, Tarpley M, Tarpley J, Terfera G, Weiser T, Lipnick M, Nabukenya M, Ozgediz D, Jayaraman S| | PubMed
  33. Author response to: Clean Cut (adaptive, multimodal surgical infection prevention programme) for low-resource settings: a prospective quality improvement study.
    Forrester JA, Starr N, Gebeyehu N, Negussie T, Weiser TG| | PubMed
  34. Early Outcome of Laparotomy Wounds in Pediatric Patients in TASH, Addis Ababa, Ethiopia: A Six-Months Prospective Study.
    Temesgen F, Gosaye A, Starr N, Kiflu W, Getachew H, Dejene B, Tadesse A, Derbew M, Negussie T| | PubMed
  35. Clean Cut (adaptive, multimodal surgical infection prevention programme) for low-resource settings: a prospective quality improvement study.
    Forrester JA, Starr N, Negussie T, Schaps D, Adem M, Alemu S, Amenu D, Gebeyehu N, Habteyohannes T, Jiru F, Tesfaye A, Wayessa E, Chen R, Trickey A, Bitew S, Bekele A, Weiser TG| | PubMed
  36. Construction and validation of UV-C decontamination cabinets for filtering facepiece respirators.
    Purschke M, Elsamaloty M, Wilde JP, Starr N, Anderson RR, Farinelli WA, Sakamoto FH, Tung M, Tam J, Hesselink L, Baer TM| | PubMed
  37. Pulse oximetry in low-resource settings during the COVID-19 pandemic.
    Starr N, Rebollo D, Asemu YM, Akalu L, Mohammed HA, Menchamo MW, Melese E, Bitew S, Wilson I, Tadesse M, Weiser TG| | PubMed
  38. COVID-19 Preparedness Within the Surgical, Obstetric, and Anesthetic Ecosystem in Sub-Saharan Africa.
    Ademuyiwa AO, Bekele A, Berhea AB, Borgstein E, Capo-Chichi N, Derbew M, Evans FM, Feyssa MD, Galukande M, Gawande AA, Gueye SM, Harrison E, Jani P, Kaseje N, Litswa L, Mammo TN, Mellin-Olsen J, Muguti G, Nabukenya MT, Ngoga E, Ntirenganya F, Rulisa S, Starr N, Tabiri S, Tadesse M, Walker I, Weiser TG, Wren SM| | PubMed
  39. Identification of injury and shock driven effects on ex vivo platelet aggregometry: A cautionary tale of phenotyping.
    Starr NE, Matthay ZA, Fields AT, Nunez-Garcia B, Callcut RA, Cohen MJ, Kornblith LZ| | PubMed
  40. The Lifebox Surgical Headlight Project: engineering, testing, and field assessment in a resource-constrained setting.
    Starr N, Panda N, Johansen EW, Forrester JA, Wayessa E, Rebollo D, August A, Fernandez K, Bitew S, Mammo TN, Weiser TG| | PubMed
  41. Value and Feasibility of Telephone Follow-Up in Ethiopian Surgical Patients.
    Starr N, Gebeyehu N, Tesfaye A, Forrester JA, Bekele A, Bitew S, Wayessa E, Weiser TG, Negussie T| | PubMed
  42. Diagnosis and management of surgical disease at Ethiopian health centres: cross-sectional survey of resources and barriers to care.
    Starr N, Carpenter S, Carvalho M, Souza A, Chin R, Kasotakis G, Worku M| | PubMed
  43. Qualitative outcomes of Clean Cut: implementation lessons from reducing surgical infections in Ethiopia.
    Mattingly AS, Starr N, Bitew S, Forrester JA, Negussie T, Bereknyei Merrell S, Weiser TG| | PubMed
  44. Global variation in anastomosis and end colostomy formation following left-sided colorectal resection.
    GlobalSurg Collaborative| | PubMed
  45. Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy.
    GlobalSurg Collaborative| | PubMed
  46. Platelet transfusion increases risk for acute respiratory distress syndrome in non-massively transfused blunt trauma patients.
    Kasotakis G, Starr N, Nelson E, Sarkar B, Burke PA, Remick DG, Tompkins RG, Inflammation and Host Response to Injury Investigators| | PubMed
  47. Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.
    GlobalSurg Collaborative| | PubMed
  48. Provision of surgical care in Ethiopia: Challenges and solutions.
    Kelly CM, Starr N, Raykar NP, Yorlets RR, Liu C, Derbew M| | PubMed
  49. Socially Responsible Surgery: Building Recognition and Coalition.
    Robinson TD, Oliveira TM, Timmes TR, Mills JM, Starr N, Fleming M, Janeway M, Haddad D, Sidhwa F, Macht RD, Kauffman DF, Dechert TA| | PubMed
  50. Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries.
    GlobalSurg Collaborative| | PubMed