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    Apr 19, 2021
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    Quality of Care in Humanitarian Surgery

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    Authors
    Chu, K M
    Trelles, M
    Ford, N P
    Affiliation
    Médecins Sans Frontières-South Africa, Johannesburg, South Africa; Department of Surgery, Johns Hopkins University, Baltimore, MD, USA; Médecins Sans Frontières–Belgium, Brussels, Belgium
    Issue Date
    2011-04-13
    Submitted date
    2011-05-26
    
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    Journal
    World Journal of Surgery
    Abstract
    Humanitarian surgical programs are set up de novo, within days or hours in emergency or disaster settings. In such circumstances, insuring quality of care is extremely challenging. Basic structural inputs such as a safe structure, electricity, clean water, a blood bank, sterilization equipment, a post-anesthesia recovery unit, appropriate medications should be established. Currently, no specific credentials are needed for surgeons to operate in a humanitarian setting; the training of more humanitarian surgeons is desperately needed. Standard perioperative protocols for the humanitarian setting after common procedures such as Cesarean section, burn care, open fractures, and amputations and antibiotic prophylaxis, and post-operative pain management must be developed. Outcome data, especially long-term outcomes, are difficult to collect as patients often do not return for follow-up and may be difficult to trace; standard databases for post-operative infections and mortality rates should be established. Checklists have recently received significant attention as an instrument to support the improvement of surgical quality; knowing which items are most applicable to humanitarian settings remains unknown. In conclusion, the quality of surgical services in humanitarian settings must be regulated. Many other core medical activities of humanitarian organizations such as therapeutic feeding, mass vaccination, and the treatment of infectious diseases, such as tuberculosis and human immunodeficiency virus, are subject to rigorous reporting of quality indicators. There is no reason why surgery should be exempted from quality oversight. The surgical humanitarian community should pull together before the next disaster strikes.
    URI
    http://hdl.handle.net/10144/141429
    DOI
    10.1007/s00268-011-1084-9
    PubMed ID
    21487849
    Additional Links
    http://www.springerlink.com/content/a570v61789454107/
    Type
    Article
    Language
    en
    ISSN
    1432-2323
    ae974a485f413a2113503eed53cd6c53
    10.1007/s00268-011-1084-9
    Scopus Count
    Collections
    Surgery

    entitlement

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