The Global Surgery Research Unit of the Latin American Indicator Research Collaboratory: An Action Model for Grassroots Collection of Lancet Commission on Global Surgery Indicators

Abstract

Background. The Lancet Commission on Global Surgery (LCoGS) recommends collection of six surgical indicators to inform surgical system strengthening and improve access to surgical care. However, a standardized practice has yet to be described to guide nations towards this endeavor via a sustainable and reproducible grassroots intervention (i.e., developing information management).Methods. A research team structure, termed a “global surgery research unit” (GSRU), was developed between a hospital in Medellin, Colombia and Rutgers-Robert Wood Johnson Medical School. The GSRU implemented a grassroots intervention in a single center over three months to study the feasibility of obtaining LCoGS indicators 1-4 via hospital medical records, administrative surveys, and patient interviews. The intervention was then retrospectively evaluated utilizing a review of implementation outcomes.Results. During the feasibility study period, 84.5% of general/ trauma surgery patients interviewed reported traveling less than two hours. The workforce includes 15 general surgeons, 34 anesthesiologists, and 9 obstetrician-gynecologists. Total surgical volume is estimated to be 15,180 procedures per year, with a 30-day postoperative mortality rate of 1.8%. Evaluation of implementation outcomes revealed grassroots, single center collection of LCoGS indicators was feasible. However, increased workforce and time commitment is required for sustainability.Conclusions. This learner-driven model introduces a feasible grassroots intervention for LCoGS indicators 1-4 collection in a single center. Grassroots interventions may inform practical collection of individual hospital indicators to inform the information management component of a hospital system. However, continued evaluation of the GSRU and methodological processes is needed to optimize model efficacy and expand indicator data collection.