Surgical Outcomes Auditing Systems in Humanitarian Organizations

Bermúdez, Luis; Carter, Victoria; Magee, William P.; Sherman, Randy; Ayala, Ruben

doi:10.1007/s00268-009-0253-6

Cited by 46 publications

(40 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In part, this is due to a difficulty with follow-up. Of 4,100 operations for cleft lip and palate by 1 organization in 40 simultaneous sites, for example, only 703 patients (17 %) returned for a 6- to 9-month postoperative visit [19]. Similarly, in a Spanish-African cooperation program for the repair of hernias, follow-up was 21 % [16].…”

Section: Resultsmentioning

confidence: 99%

Charitable Platforms in Global Surgery: A Systematic Review of their Effectiveness, Cost‐Effectiveness, Sustainability, and Role Training

2014

View full text Add to dashboard Cite

ObjectiveThis study was designed to propose a classification scheme for platforms of surgical delivery in low- and middle-income countries (LMICs) and to review the literature documenting their effectiveness, cost-effectiveness, sustainability, and role in training. Approximately 28 % of the global burden of disease is surgical. In LMICs, much of this burden is borne by a rapidly growing international charitable sector, in fragmented platforms ranging from short-term trips to specialized hospitals. Systematic reviews of these platforms, across regions and across disease conditions, have not been performed.MethodsA systematic review of MEDLINE and EMBASE databases was performed from 1960 to 2013. Inclusion and exclusion criteria were defined a priori. Bibliographies of retrieved studies were searched by hand. Of the 8,854 publications retrieved, 104 were included.ResultsSurgery by international charitable organizations is delivered under two, specialized hospitals and temporary platforms. Among the latter, short-term surgical missions were the most common and appeared beneficial when no other option was available. Compared to other platforms, however, worse results and a lack of cost-effectiveness curtailed their role. Self-contained temporary platforms that did not rely on local infrastructure showed promise, based on very few studies. Specialized hospitals provided effective treatment and appeared sustainable; cost-effectiveness evidence was limited.ConclusionsBecause the charitable sector delivers surgery in vastly divergent ways, systematic review of these platforms has been difficult. This paper provides a framework from which to study these platforms for surgery in LMICs. Given the available evidence, self-contained temporary platforms and specialized surgical centers appear to provide more effective and cost-effective care than short-term surgical mission trips, except when no other delivery platform exists.

show abstract

Section: Resultsmentioning

confidence: 99%

Charitable Platforms in Global Surgery: A Systematic Review of their Effectiveness, Cost‐Effectiveness, Sustainability, and Role Training

2014

View full text Add to dashboard Cite

show abstract

“…Follow-up rates have been correspondingly low: among medical mission groups that do provide postoperative care, rates range from 5% to 35% of patients [58]. Cleft missions groups have made progress in monitoring surgical outcomes, for instance through the development of outcomes databases [18, 43, 49, 62]. However, an increased focus on outcomes is needed.…”

Section: Building Capacity While Addressing Specific Needs: a Diagmentioning

confidence: 99%

An Opportunity for Diagonal Development in Global Surgery: Cleft Lip and Palate Care in Resource-Limited Settings

Patel

Hoyler

Maine

et al. 2012

Plastic Surgery International

View full text Add to dashboard Cite

Global cleft surgery missions have provided much-needed care to millions of poor patients worldwide. Still, surgical capacity in low- and middle-income countries is generally inadequate. Through surgical missions, global cleft care has largely ascribed to a vertical model of healthcare delivery, which is disease specific, and tends to deliver services parallel to, but not necessarily within, the local healthcare system. The vertical model has been used to address infectious diseases as well as humanitarian emergencies. By contrast, a horizontal model for healthcare delivery tends to focus on long-term investments in public health infrastructure and human capital and has less often been implemented by humanitarian groups for a variety of reasons. As surgical care is an integral component of basic healthcare, the plastic surgery community must challenge itself to address the burden of specific disease entities, such as cleft lip and palate, in a way that sustainably expands and enriches global surgical care as a whole. In this paper, we describe a diagonal care delivery model, whereby cleft missions can enrich surgical capacity through integration into sustainable, local care delivery systems. Furthermore, we examine the applications of diagonal development to cleft care specifically and global surgical care more broadly.

show abstract

“…7,13,14 Can such a methodology be employed in a charitable mission setting? While the feasibility of studies involving medical mission patients with interviews and follow-up has been demonstrated, 5 no prospective satisfaction study has yet been conducted with medical mission patients. We therefore conducted a small prospective cohort study containing both these elements, assessing the relationship between pre-operative expectations and post-operative outcomes and level of satisfaction in parents of children receiving cleft lip or cleft palate (CL/CP) repair from surgeons of the Operation Smile team in Tegucigalpa, Honduras.…”

Section: Introductionmentioning

confidence: 98%

“…One large and well known agency, Operation Smile, has provided CL/CP repairs in developing countries since 1982. 4,5 With CL/CP repair teams consisting of plastic surgeons, anaesthetists and other health-care professionals, and the co-operation of local surgeons and volunteers, Operation Smile may perform 200 operations during a 1-week trip. Families travel many miles to reach the surgical facility so that their children can receive medical care they could not otherwise afford.…”

Section: Introductionmentioning

confidence: 99%

Parents’ satisfaction with repair of paediatric cleft lip/cleft palate in Honduras

Rivera

Hexem

Womer

et al. 2013

Paediatrics and International Child Health

View full text Add to dashboard Cite

show abstract

Surgical Outcomes Auditing Systems in Humanitarian Organizations

Abstract: The current outcomes evaluation system has proven beneficial in tracking patient outcomes, auditing surgical performance, and providing feedback to surgeons and other team members. Challenges are discussed.

Cited by 46 publications

References 42 publications

Charitable Platforms in Global Surgery: A Systematic Review of their Effectiveness, Cost‐Effectiveness, Sustainability, and Role Training

Charitable Platforms in Global Surgery: A Systematic Review of their Effectiveness, Cost‐Effectiveness, Sustainability, and Role Training

An Opportunity for Diagonal Development in Global Surgery: Cleft Lip and Palate Care in Resource-Limited Settings

Parents’ satisfaction with repair of paediatric cleft lip/cleft palate in Honduras

Contact Info

Product

Resources

About