Rates, Barriers, and Facilitators of Outcome Collection on Hand Surgery Outreach to Low- and Middle-Income Countries - PubMed (original) (raw)

Rates, Barriers, and Facilitators of Outcome Collection on Hand Surgery Outreach to Low- and Middle-Income Countries

Jessica M Welch et al. Hand (N Y). 2023 Jul.

Abstract

Background: Global outreach to low- and middle-income countries (LMICs) continues to grow in an effort to improve global health. The practice of quality measurement is empirically lacking from surgical outreach trips to LMICs, which may limit the safety and quality of care provided. Using convergent mixed-methods, we aimed to: (1) identify and evaluate barriers and facilitators to outcome measure collection; and (2) report the sample rate of such collection on hand surgery outreach trips to LMICs.

Methods: Surgeons and administrators involved in hand surgery outreach trips completed a survey regarding rates of outcome measure collection and a semi-structured interview to explore barriers and facilitators of outcome collection. Survey data were reported descriptively. Interviews were recorded and transcribed, and excerpts were categorized according to the Pettigrew framework for strategic change (content, process, and context). Results were combined through convergent mixed-methods analysis.

Results: Thirty-three participants completed the survey, and 21 participated in interviews. Rates of collection were the most common for total case number (83%) and patient mortality (65%). Longitudinal outcomes (eg, patient follow-up or time away from work) were less frequently recorded (9% and 4%, respectively). Content analysis revealed barriers related to each domain of the Pettigrew framework.

Conclusions: This analysis demonstrates low levels of outcome collection on outreach trips and identifies priority areas for improvement. Developing context-specific solutions aimed at addressing barriers (eg, resource/database availability) and promoting facilitators (eg, collaborative relationships) may encourage higher rates of collection, which stands to improve patient safety, quality of care, and accountability when conducting outreach trips to LMICs.

Keywords: global surgery; low- and middle-income countries; outcome measurement; outreach trips; surgical outreach.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.

Figure 1.

Pettigrew framework for strategic change with domains used to develop semi-structured interview guide and conduct content analysis. Adapted from Pettigrew.

Figure 2.

Figure 2.

Map illustrating countries in which participants have provided surgical care on outreach trips.

Figure 3.

Figure 3.

Diagram of the convergent analysis allowing integration of the quantitative and qualitative data.

References

    1. Meara JG, Leather AJM, Hagander L, et al. Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet. 2015;386(9993):569-624. doi: 10.1016/S0140-6736(15)60160-X. -DOI -PubMed
    1. Alkire BC, Shrime MG, Dare AJ, et al. Global economic consequences of selected surgical diseases: a modelling study. Lancet Glob Health. 2015;3(suppl 2):S21-S27. doi: 10.1016/S2214-109X(15)70088-4. -DOI -PMC -PubMed
    1. Agarwal-Harding KJ, von Keudell A, Zirkle LG, et al. Understanding and addressing the global need for orthopaedic trauma care. J Bone Joint Surg Am. 2016;98(21):1844-1853. doi: 10.2106/JBJS.16.00323. -DOI -PubMed
    1. Bido J, Ghazinouri R, Collins JE, et al. A conceptual model for the evaluation of surgical missions. J Bone Joint Surg Am. 2018;100(6):e35. doi: 10.2106/JBJS.17.00689. -DOI -PMC -PubMed
    1. Maki J, Qualls M, White B, et al. Health impact assessment and short-term medical missions: a methods study to evaluate quality of care. BMC Health Serv Res. 2008;8:121. doi: 10.1186/1472-6963-8-121. -DOI -PMC -PubMed

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