Lancet Commission in Global Surgery June 2014. Parliament of Sierra Leone.
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Transcript of Lancet Commission in Global Surgery June 2014. Parliament of Sierra Leone.
Lancet Commission in Global Surgery
June 2014
Parliament of Sierra Leone
Lancet Commission in Global SurgeryHouse of Parliament
Session # 1June 2014
Resolutions• Key messages• Metrics• Recommendations• Future Research• Requirements for safe surgery
Terms of Reference• You will need your smartphone or computer• If you have neither with you – Katie will get you
some paper• Use your subject line for the title of the resolution• You may vote up or down on a resolution or
change/edit it in your vote• You may also use your own ideas• “Vote early and often”• You may NOT vote to impeach the commission
chairs
Key Messages• What is a Key Message? eg: GH2035 • Let’s get started:– Pull up a new email message– [email protected]– Type “Key Messages” in subject line– You may vote for ONLY 3 (THREE) key messages – You may make up your own messages– Or, mix and match
Key Messages (type “Key Messages” in subject line)
1. Rights/equity (Farmer resolution): 5 billion people do not have access to safe affordable surgical and anesthesia care when needed
2. Structure/process (Jim Kim resolution): Surgery is an indivisible, indispensible component of a properly functioning health system
3. Governance/management (Eva Hanciles resolution): Huge gains in surgical care provision are possible with already existing health care systems by employing proper governance and management principles and training processes
4. Economic (Yamey/Conteh/Yip resolution): Investments in surgery are pro growth, cost effective, have a positive ROI etc…
Metrics(yes or no on all)
1. Proximity: Percent of population within 2 hours to a facility capable of safe emergency surgery
2. Timeliness: Emergency surgery performed within 24 hours3. Workforce: Trained providers per population4. Throughput: Procedure rate per population5. Elective to emergency procedure ratio6. Capacity: Percent of district-level hospitals meeting requirements for safe
surgery7. Outcomes: Peri-Operative Mortality Rate (all procedures or bellwether)8. Financial Protection: Percent of population falling into poverty or incurring
catastrophic expenditure due to out-of-pocket healthcare expenditure *9. Mixed: Unmet need for surgical care10. Strategic Planning: Inclusion of surgery within national or regional health
plans
Recommendations• Your own ideas• 3 and ONLY THREE• Be as specific as possible• Direct it to a specific stakeholder if appropriate
Recommendations - Stakeholders• Govts/MOH/MOF• WHO• WBG• USAID• Foundations – Clinton/Gates• NGOs• Academic medical centers – HIC or LMICS• Colleges and professional societies – HIC or LMICS• Industry• Patients
Future Research Agenda• Choose 3 on your own• What are the 3 most important things in which to invest research
resources in the next 5-10 years?• Potential categories
– Access– Burden– Quality– Safety– Workforce– Implementation– Benchmarking– Cost of care delivery– Barriers to access/care– Patient experience
Requirements for Safe Surgeryyes or no on all
1. Staff: A trained surgical provider and team2. Staff: A trained anesthesia provider and team3. Staff: Postop nursing care, and physiological observations4. Staff: 24/7 surgical cover to review & assess patients5. Stuff: Equipment, supplies, consumables, antibiotics and pain meds6. Stuff: Equipment maintenance7. Stuff: Sterilization capability8. Stuff: Screened and cross-matched blood9. Stuff/Staff protection: Gloves, and the ability to test for HIV10. Process: Safe surgery checklist *11. Process: Preoperative risk assessment and operation planning