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Measuring Surgical Outcomes Surgery, like any other international development program, requires careful impact assessment. Monitoring and evaluation has several important benefits, including its ability to assess whether the program is having its desired effect.
This information allows surgeons and administrators to identify and improve upon weaknesses in the healthcare delivery system, resulting in better patient care. This assessment also provides effectiveness data to stakeholders. With proper reporting, funders can be confident in the reach of their investment, governments can place their trust in the organization, and patients can Aravind eye care key success factor assured that their doctors are delivering quality care.
Measuring Surgical Quality Birkmeyer, Dimick and Birkmeyer outline three ways to measure surgical quality: Procedure volume is the most common of these variables and is often used as a proxy for surgical quality, due the loose correlation between high procedure volume and improved long-term survival.
For example, primary care physicians are often scored according to the fraction of their patients that receive appropriate mammograms, retinal exams and vaccinations. This methodology might be applied to surgery by tracking the specific type of procedure used, the kind of anesthesia applied, or the combination of postoperative medications provided.
The advantages of this method are that it directly reflects patient care and that it provides a clear link to quality improvement strategies. The downside is that it is not known which processes are most important. Medical care is comprised of hundreds of processes, many of which are often taken for granted, making it difficult to discern which activities are most associated with positive outcomes.
The Importance of Measuring Surgical Outcomes The research studies discussed below illustrate the necessity of measuring not only outputs, but also outcomes. This case clearly demonstrates the importance of going beyond structural and procedural measures to focus on surgical outcomes.
Kikuyu Eye Unit, Kenya A year-long observational study of the eye unit of Kikuyu Hospital outside Nairobi, Kenya, measured whether the introduction of prospective outcome monitoring influenced surgical outcomes.
This study demonstrates that the very process of monitoring outcomes improves these outcomes above any improvements made to healthcare delivery systems following outcome analysis.
Key issues to consider when designing a monitoring and evaluation system include: What defines a successful surgery? Establishing measurable standards is essential for quantifying outcomes. For emergency surgery, the operation is considered successful simply if the patient lives.
However, defining a positive outcome for procedures that treat non-life-threatening conditions requires a bit more nuance. For example, what change in visual acuity score is required for cataract surgery to be considered helpful?
What degree of closure is necessary for obstetric fistula repair to be successful? How long does it take for the true outcome of a surgery to become apparent?
Devising healthcare systems that facilitate post-operative care—through outreach trips, a network of community health workers, mHealth applications, etc. Patient Reported Wellbeing and Clinical Analysis: Both patient perceptions of wellbeing and clinical analysis of health should be included in outcome measurement.
Monitoring and evaluation systems must be able to analyze both subjective, nuanced patient accounts, and scientific, standardized clinical measurements. It is important to standardize the way in which data is initially recorded and subsequently transcribed in order to minimize error.
This will likely require extensive training, but is essential to produce valid results. Once data has been analyzed, organizations can use the results to report to patients, staff, donors, colleagues, governmental bodies, and other partners.
Given the complexity of the statistics, it is important to plan the best way to present the data to each audience so that the information is both understandable and comprehensive.
Aravind Eye Care System With the goal of eradicating blindness in India, the Aravind Eye Care System has created a revolutionary model for delivering healthcare to the poor. In addition to the hospitals at the core of the organization, the eye care system consists of a manufacturing center that produces lenses, sutures, and medications at a low cost, as well as a training institute, a research institute, an eye bank, and an outreach program.
A study of adverse events found that when compared to the Royal College of Ophthalmologists in the U. K, Aravind had lower or comparable rates of every type of complication. The organization provides nearly 5, surgeries each year to burn victims, children with cleft lips and cleft palates, and patients with hand deformities.
While ReSurge carefully tracks the number of surgeries that they have sponsored, they also focus on outcomes.
ReSurge has ensured that their surgeries have the desired impact on patients by instituting a continuum of care that monitors patients as they recover. Without gathering information directly from patients, the exact social and economic impact of the organization remains unknown.
Innovations for Improving Surgical Outcomes 26 As the demand and volume of surgery has increased dramatically in all parts of the world, ensuring the safe delivery of high quality surgical care is a major public health concern. Surgical Apgar Score The Surgical Apgar score was developed as a simple, low-cost metric to provide rapid feedback to surgery teams in diverse settings.The health care organization investigated in this case study is Aravind Eye Care system (AECS), popularly known as the McDonald’s of cataract surgery.
The present study identifies the supply chain model used by AECS and elaborates how supply chain management in various operations of AECS contributes to its success. BCM, BCM and Raspberry Pi 3. For Raspberry Pi 3, Broadcom have supported us with a new SoC, BCM This retains the same basic architecture as its predecessors BCM and BCM, so all those projects and tutorials which rely on the precise details of the Raspberry Pi hardware will continue to work.
Muhammad Yunus is that rare thing: a bona fide visionary. His dream is the total eradication of poverty from the world. In , against the advice of banking and government officials, Yunus established Grameen, a bank devoted to providing the poorest of Bangladesh with minuscule loans.
Prof. Manik Talwani, Emeritus Professor, Rice University, USA About the speaker: Manik Talwani is one of the pioneers of modern geophysics and contributed greatly to our understanding of how oceans and continents evolve.
Another factor, key to the success of the Aravind system, is the high quality of the surgery. While if done well, modern cataract surgery restores vision to a ‘perfect’.
CSK have climbed to the top of the table after this massive run win. That's it from our coverage of this game. I've been Sagar Chawla, and on behalf of Nikhil Jadhav, Akshay Maanay, Abhinand.