TED Community » Erica Frenkel

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  A reply on Conversation: How do we make safe surgery part of the global health agenda?

  Feb 23 2012: I would also add that there is a cost to setting up and strengthening surgical care but there is a significant cost (some would argue much greater) to having a population (and productive workforce) that is incapacitated by injuries or conditions that would otherwise be surgically treatable permitting them to contribute more to society. You can see some of the work that some researchers are trying to do on this issue here: http://hhi.harvard.edu/programs-and-research/74-burden-of-surgical-disease

• A reply on Conversation: How do we make safe surgery part of the global health agenda?

  Feb 23 2012: I don't think there is a single answer for this question. The issue you bring up of training surgical staff is one that we keep coming back to. One of the ways some countries deal with this challenge is "task shifting". That is, training more people at lower levels to conduct specific health-related work but perhaps not at the level of a medical doctor. Training for these positions is much less time-consuming and expensive and so can work. Here is an interesting module of the topic: http://www.uniteforsight.org/health-workers-course/module4
  
  With regards to the local vs. global issue, I think there are very few issues that are truly local any more. But it is a heated issue - whose "responsibility" is it to ensure that everyone is cared for and treated when they need it? If the government of a given country can't afford to provide adequate care/treatment, does it fall to those countries that can to provide it? Is there a third way that collaborates and works to bring all governments to a place where they can provide care and treatment for their population?

• A comment on Conversation: How do we make safe surgery part of the global health agenda?

  Feb 23 2012: So let's take this thread in a different direction a little. My company has chosen to approach the need for safer surgery and perioperative care by working on infrastructure and pursuing partnerships with organizations that can leverage the impact of our machine and address other areas that need to be strengthened along the cotinuum of safe surgery. What are some of the areas that you all are working in to strengthen surgical care around the world? Have you been able to quantify (or qualify) an impact of your work? What would you have needed to increase that impact?

• A reply on Conversation: How do we make safe surgery part of the global health agenda?

  Feb 23 2012: Agreed. I think the GIEESC (WHO) and other organizations are beginning to recognize the need to improve safety in surgery. With this has come an awareness of the lack of data we have on the issue that can inform policymakers and funders as they determine their priorities going forward. I wonder how we can translate efforts by WHO, JCI and World Alliance for Patient Safety that you mention into improved surgical outcomes and support for training and infrastructure development (among other areas in the field of surgery).

• A reply on Conversation: How do we make safe surgery part of the global health agenda?

  Feb 23 2012: Chiro, you're absolutely right - quantifying quality is one of the biggest challenges in any field. In challenging environments that lack human and financial capital to pursue measurements like these it becomes herculean. The WHO has developed a tool to begin to come up with metrics for quality that is worth a look. You can download it here: http://www.who.int/surgery/publications/WHOtoolSituationalAnalysisEESC.pdf

• A reply on Conversation: How do we make safe surgery part of the global health agenda?

  Feb 23 2012: Bruce, I'd love to hear more about the "bottom up approach" and how you were able to get funding/support internally and externally. Do you think yours is a model that would work internationally?

• A reply on Conversation: How do we make safe surgery part of the global health agenda?

  Feb 23 2012: Kathering, you make a great point - that safe surgery is not confined to the OR. I would think all actors - obvious and not obvious - would need to be involved this conversations. Naturally surgeons and their teams need to perform the surgery itself, but if we think about before and after an event in addition to during, there are a host of opportunities to strengthen the team approach that would need to begin with a strong health system. I'm thinking about referral systems and transportation to permitting timely surgery, intake/triage plans at the hospital to help prioritize patients, perioperative and recovery support/infrastructure, among many others.

• A comment on Conversation: How do we make safe surgery part of the global health agenda?

  Feb 23 2012: Hi everyone, I'm hoping we can get a good conversation going about your thoughts on the state of surgery in resource-constrained environments and how we might improve access to and quality of surgery in these areas. I'd especially love to hear about your experiences with successful and unsuccessful attempts to bring this issue to the fore of global health funders'/practitioners' priorities.