The governance of overseas surgical collaborations – BFIRST/BSSH

Jemec, Barbara; Lam, Wee Leon; Hodgson, Stephen; Jones, John; Eckersley, Robert J.; Nyamulani, Nohakhelha; Riaz, Mehr Muhammad Adeel; Fell, M. R.; Nicholas, Rebecca; Bhopal, Rickesh; Mendis, Kapila; Khan, Muzammil; Sommerlad, Brian C.

doi:10.1016/j.bjps.2020.08.022

Cited by 8 publications

(11 citation statements)

References 13 publications

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“…These include the consensus paper compiled by the British Society for Surgery of the Hand and British Foundation for International Reconstructive Surgery and Training, which emphasized consent for both surgery and photography being available in the local language and done with local translators or providers. 9 Using these recommendations, we have also developed a single form consent for surgical procedures and sharing of multimedia content ( see Document, Supplemental Digital Content 2 , which shows the consent form template for surgical procedures and sharing of multimedia content, http://links.lww.com/PRS/F395). Of note, the objective and scope of this study focused primarily on informed consent for procedures and social media use.…”

Section: Discussionmentioning

confidence: 99%

Informed Consent Practices in Global Surgery among Plastic Surgery Organizations

Thadikonda

Zhang

Bruhn

et al. 2022

Plastic &Amp; Reconstructive Surgery

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Background: Global surgery organizations often serve vulnerable and complex patient populations, but there is limited knowledge on the protocols used to obtain informed consent for procedures and content sharing. Methods: The Plastic Surgery Foundation Volunteers in Plastic Surgery database was queried for organizations actively involved in global surgery. Seventy-nine organizations received email invitations to participate in a survey study regarding their protocols for obtaining consent for procedures and sharing multimedia content. Results: A total of 17 organizations (22 percent) completed the survey. All were active for at least 10 years, and 15 of 17 organizations (88 percent) organized at least two mission trips annually. Fifteen of 17 organizations (88 percent) reported obtaining written consent for surgical procedures. Eight of 17 organizations, less than half (46 percent), used a written consent form that was created jointly with the local hospital. For sharing content related to global surgery experiences, 12 of 16 (75 percent) obtained some form of written consent, whereas one of 16 (6 percent) did not routinely obtain any consent. Organizations shared content most commonly through their websites and Facebook. All organizations reported using interpreters to obtain informed consent at least some of the time. Ten of 16 (62 percent) reported that they relied primarily on volunteers or community members to provide informal interpretation assistance, rather than formally trained professional interpreters. Conclusions: Practices related to obtaining informed consent vary widely among global surgery organizations. The development of standardized protocols and guidelines will ensure that global health organizations, in collaboration with their local partners, properly obtain informed consent for procedures and sharing publicly viewable content.

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Section: Discussionmentioning

confidence: 99%

Informed Consent Practices in Global Surgery among Plastic Surgery Organizations

Thadikonda

Zhang

Bruhn

et al. 2022

Plastic &Amp; Reconstructive Surgery

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“…Guideline elements f Sources Partnerships Establishment of bidirectional partnerships that are collaborative are critical 6 [29,32,41,48,52,57] Short-term trips should be a component of long-term partnerships to mitigate adverse consequences, ensure partnerships do not end abruptly, and to ensure sustainability 5 [28,29,33,41,57] Engage with partners outside of the local hospital, such as public health officials, community health workers, local pharmacies, local NGOs, or local government agencies 11 [28,33,41,46,50,53,[55][56][57][58] Foster coalitions between outreach organizations to streamline care 2 [42,47] Professional development Activities should align with the goals of the public sector, follow local patient protection practices, and meet local quality standards 6 [32,33,36,48,50,56] Do not practice outside of scope, which is especially important when trainees (including students, residents, and fellows) are assisting during the trip 11 [26, 28-30, 33, 36, 39, 43, 50, 53] Follow guidelines for using any expired or reused supplies, leave any equipment necessary for follow-up care or future planned procedures with the local hospital 3 [28,30,32] Have policies in place for the informed consent and media collection process, including obtaining patient consent for any photography and research 5 [28,33,39,42,45] Comm...…”

Section: Domainmentioning

confidence: 99%

Capacity Building During Short‐Term Surgical Outreach Trips: A Review of What Guidelines Exist

et al. 2022

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Introduction While short-term surgical outreach trips improve access to care in low- and middle-income countries (LMIC), there is rising concern about their long-term impact. In response, many organizations seek to incorporate capacity building programs into their outreach efforts to help strengthen local health systems. Although leading organizations, like the World Health Organization (WHO), advocate for this approach, uniform guidelines are absent. Methods We performed a systematic review, using search terms pertaining to capacity building guidelines during short-term surgical outreach trips. We extracted information on authorship, guideline development methodology, and guidelines relating to capacity building. Guidelines were classified according to the Global-QUEST framework, which outlines seven domains of capacity building on surgical outreach trips. Guideline development methodology frequencies and domain classifications frequencies were calculated; subsequently, guidelines were aggregated to develop a core guideline for each domain. Results A total of 35 studies were included. Over 200 individual guidelines were extracted, spanning all seven framework domains. Guidelines were most frequently classified into Coordination and Community Impact domains and least frequently into the Finance domain. Less than half (46%) of studies collaborated with local communities to design the guidelines. Instead, guidelines were predominantly developed through author trip experience. Conclusion As short-term surgical trips increase, further work is needed to standardize guidelines, create actionable steps, and promote collaborations in order to promote accountability during short-term surgical outreach trips.

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“…It is worth noting that the only two NGOs who continued to perform reconstructive surgery over the last year, albeit in a reduced capacity, have been those with a sustainable, year-round presence in the country in which they operate. For many international collaborations that have been running for many years, the opportunity to support a transition to surgical care delivered by local surgeons, with additional funding support, could be considered [6]. In the short-term, some NGOs have switched to fundraise for PPE, hygiene products and basic medical equipment [1].…”

Section: Number Of Responsesmentioning

confidence: 99%

“…Pre-pandemic, many non-governmental organisations (NGOs) routinely facilitated life-changing reconstructive surgery in Africa, using a collaborative international model to deliver patient care. Previously referred to as short-term reconstructive missions, these collaborations involved a partnership between visiting and local surgical teams [1,6]. The aim of this study was to quantify the impact of the COVID-19 pandemic on the planning and provision of international reconstructive collaborations in Africa.…”

Section: Introductionmentioning

confidence: 99%

The impact of the COVID-19 pandemic on international reconstructive collaborations in Africa

et al. 2021

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Background The SARS-CoV-2 (COVID-19) pandemic has catalysed a widespread humanitarian crisis in many low- and middle-income countries around the world, with many African nations significantly impacted. The aim of this study was to quantify the impact of the COVID-19 pandemic on the planning and provision of international reconstructive collaborations in Africa. Methods An anonymous, 14-question, multiple choice questionnaire was sent to 27 non-governmental organisations who regularly perform reconstructive surgery in Africa. The survey was open to responses for four weeks, closing on the 7 th of March 2021. A single reminder was sent out at 2 weeks. The survey covered four key domains: (1) NGO demographics; (2) the impact of COVID-19 on patient follow-up; (3) barriers to the safe provision of international surgical collaborations during COVID-19; (4) the impact of COVID-19 on NGO funding. Results A total of ten reconstructive NGOs completed the survey (response rate, 37%). Ethiopia ( n = 5) and Tanzania ( n = 4) were the countries where most collaborations took place. Plastic, reconstructive and burns surgery was the most common sub-speciality ( n = 7). For NGOs that did not have a year-round presence in country ( n = 8), only one NGO was able to perform reconstructive surgery in Africa during the pandemic. The most common barrier identified was travel restrictions (within country, n = 8 or country entry-exit, n = 7). Pre-pandemic, 1547 to ≥ 1800 patients received reconstructive surgery on international surgical collaborations. After the outbreak, 70% of NGOs surveyed had treated no patients, with approximately 1405 to ≥ 1640 patients left untreated over the last year. Conclusions The COVID-19 pandemic has placed huge pressures on health services and their delivery across the globe. This theme has extended into international surgical collaborations leading to increased unmet surgical needs in low- and middle-income countries. Level of evidence: Not gradable. Supplementary Information The online version contains supplementary material available at 10.1007/s00238-021-01892-4.

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The governance of overseas surgical collaborations – BFIRST/BSSH

Cited by 8 publications

References 13 publications

Informed Consent Practices in Global Surgery among Plastic Surgery Organizations

Informed Consent Practices in Global Surgery among Plastic Surgery Organizations

Capacity Building During Short‐Term Surgical Outreach Trips: A Review of What Guidelines Exist

The impact of the COVID-19 pandemic on international reconstructive collaborations in Africa

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