Short-term surgical trips: local collaboration and its effects on complications and patient satisfaction
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ORIGINAL ARTICLE
Short‑term surgical trips: local collaboration and its effects on complications and patient satisfaction Ameer Al‑Hadidi1 · Hossam Alslaim2,3 · Malik Ghawanmeh3 · Farah Alfarajat3 · Hani Habra4 · Pavan Brahmamdam5 · Nathan Novotny5 Accepted: 29 April 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Short-term surgical missions can provide communities in need with desired expertise; however, it is uncertain who will manage the complications after visiting experts leave. Poor outcomes, decreased patient satisfaction, and tension on the healthcare system develop when local providers, often excluded from the initial patient care, are unable to cope with subsequent morbidity. Methods Two-year retrospective review of pediatric general, plastic, and reconstructive surgery, and urology cases performed by a relief organization in the developing world. Case complexity and postoperative complications were analyzed. Phone interviews conducted with patients/families to quantify postoperative outcomes and satisfaction. Results 474 surgeries were performed on pediatric patients with 60% response rate. Respondents stratified into three levels of complexity: 159 simple, 72 intermediate, and 54 advanced surgeries. Six (2.1%) high-level complications occurred. No association between the complexity of the surgery and the occurrence of a complications. 83.5% were satisfied with outcomes and > 92% were happy with the provided support. Conclusion Facilitating visiting and local surgeons performing cases together increases the expertise of local providers, strengthens infrastructure, and establishes clear follow-up. Despite complications, patients and families continued to recommend care to family and friends by the relief organization and were happy with support from local providers. Engaging local providers is the gold-standard for short-term trips. Keywords Global health · Short-term surgical trips · Surgical complications · International collaboration
Introduction There have been an increasing number of short-term surgical missions (STSMs), where providers travel abroad to perform a large number of procedures in a short period of time. * Ameer Al‑Hadidi [email protected] 1
Department of General Surgery, Beaumont Health, 3535 W. 13 Mile Rd Ste 307, Royal Oak, MI 48073, USA
2
Department of General Surgery, Medical College of Georgia, Augusta, Georgia
3
Jordan University of Science and Technology, Irbid, Jordan
4
Department of Computational Medicine and Bioinformatics, University of Michigan Medical School, Ann Arbor, MI, USA
5
Department of Pediatric Surgery, Beaumont Children’s, Beaumont Health, Royal Oak, MI, USA
Despite good intentions, the ethics of STSMs have been questioned; including management of postoperative complications, patient satisfaction with care, involvement, and education of local providers, cost effectiveness, and overall sustainability [1–3]. Commonly, local providers are excluded from participating in patient care which takes inc
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