Capacity Assessment Tool to Promote Capacity Building in Global Orthopaedic Surgical Outreach.
Journal
The Journal of bone and joint surgery. American volume
ISSN: 1535-1386
Titre abrégé: J Bone Joint Surg Am
Pays: United States
ID NLM: 0014030
Informations de publication
Date de publication:
16 08 2023
16 08 2023
Historique:
medline:
17
8
2023
pubmed:
15
6
2023
entrez:
15
6
2023
Statut:
ppublish
Résumé
A growing number of nongovernmental organizations from high-income countries aim to provide surgical outreach for patients in low- and middle-income countries in a manner that builds capacity. There remains, however, a paucity of measurable steps to benchmark and evaluate capacity-building efforts. Based on a framework for capacity building, the present study aimed to develop a Capacity Assessment Tool for orthopaedic surgery (CAT-os) that could be utilized to evaluate and promote capacity building. To develop the CAT-os tool, we utilized methodological triangulation-an approach that incorporates multiple different types of data. We utilized (1) the results of a systematic review of capacity-building best practices in surgical outreach, (2) the HEALTHQUAL National Organizational Assessment Tool, and (3) 20 semistructured interviews to develop a draft of the CAT-os. We subsequently iteratively used a modified nominal group technique with a consortium of 8 globally experienced surgeons to build consensus, which was followed by validation through member-checking. The CAT-os was developed and validated as a formal instrument with actionable steps in each of 7 domains of capacity building. Each domain includes items that are scaled for scoring. For example, in the domain of partnership, items range from no formalized plans for sustainable, bidirectional relationships (no capacity) to local surgeons and other health-care workers independently participating in annual meetings of surgical professional societies and independently creating partnership with third party organizations (optimal capacity). The CAT-os details steps to assess capacity of a local facility, guide capacity-improvement efforts during surgical outreach, and measure the impact of capacity-building efforts. Capacity building is a frequently cited and commendable approach to surgical outreach, and this tool provides objective measurement to aid in improving the capacity in low and middle-income countries through surgical outreach.
Sections du résumé
BACKGROUND
A growing number of nongovernmental organizations from high-income countries aim to provide surgical outreach for patients in low- and middle-income countries in a manner that builds capacity. There remains, however, a paucity of measurable steps to benchmark and evaluate capacity-building efforts. Based on a framework for capacity building, the present study aimed to develop a Capacity Assessment Tool for orthopaedic surgery (CAT-os) that could be utilized to evaluate and promote capacity building.
METHODS
To develop the CAT-os tool, we utilized methodological triangulation-an approach that incorporates multiple different types of data. We utilized (1) the results of a systematic review of capacity-building best practices in surgical outreach, (2) the HEALTHQUAL National Organizational Assessment Tool, and (3) 20 semistructured interviews to develop a draft of the CAT-os. We subsequently iteratively used a modified nominal group technique with a consortium of 8 globally experienced surgeons to build consensus, which was followed by validation through member-checking.
RESULTS
The CAT-os was developed and validated as a formal instrument with actionable steps in each of 7 domains of capacity building. Each domain includes items that are scaled for scoring. For example, in the domain of partnership, items range from no formalized plans for sustainable, bidirectional relationships (no capacity) to local surgeons and other health-care workers independently participating in annual meetings of surgical professional societies and independently creating partnership with third party organizations (optimal capacity).
CONCLUSIONS
The CAT-os details steps to assess capacity of a local facility, guide capacity-improvement efforts during surgical outreach, and measure the impact of capacity-building efforts. Capacity building is a frequently cited and commendable approach to surgical outreach, and this tool provides objective measurement to aid in improving the capacity in low and middle-income countries through surgical outreach.
Identifiants
pubmed: 37319177
doi: 10.2106/JBJS.23.00020
pii: 00004623-202308160-00013
doi:
Types de publication
Systematic Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1295-1300Informations de copyright
Copyright © 2023 by The Journal of Bone and Joint Surgery, Incorporated.
Déclaration de conflit d'intérêts
Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article ( http://links.lww.com/JBJS/H572 ).
Références
Chao TE, Sharma K, Mandigo M, Hagander L, Resch SC, Weiser TG, Meara JG. Cost-effectiveness of surgery and its policy implications for global health: a systematic review and analysis. Lancet Glob Health. 2014 Jun;2(6):e334-45.
Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, Amann M, Anderson HR, Andrews KG, Aryee M, Atkinson C, Bacchus LJ, Bahalim AN, Balakrishnan K, Balmes J, Barker-Collo S, Baxter A, Bell ML, Blore JD, Blyth F, Bonner C, Borges G, Bourne R, Boussinesq M, Brauer M, Brooks P, Bruce NG, Brunekreef B, Bryan-Hancock C, Bucello C, Buchbinder R, Bull F, Burnett RT, Byers TE, Calabria B, Carapetis J, Carnahan E, Chafe Z, Charlson F, Chen H, Chen JS, Cheng AT, Child JC, Cohen A, Colson KE, Cowie BC, Darby S, Darling S, Davis A, Degenhardt L, Dentener F, Des Jarlais DC, Devries K, Dherani M, Ding EL, Dorsey ER, Driscoll T, Edmond K, Ali SE, Engell RE, Erwin PJ, Fahimi S, Falder G, Farzadfar F, Ferrari A, Finucane MM, Flaxman S, Fowkes FG, Freedman G, Freeman MK, Gakidou E, Ghosh S, Giovannucci E, Gmel G, Graham K, Grainger R, Grant B, Gunnell D, Gutierrez HR, Hall W, Hoek HW, Hogan A, Hosgood HD 3rd, Hoy D, Hu H, Hubbell BJ, Hutchings SJ, Ibeanusi SE, Jacklyn GL, Jasrasaria R, Jonas JB, Kan H, Kanis JA, Kassebaum N, Kawakami N, Khang YH, Khatibzadeh S, Khoo JP, Kok C, Laden F, Lalloo R, Lan Q, Lathlean T, Leasher JL, Leigh J, Li Y, Lin JK, Lipshultz SE, London S, Lozano R, Lu Y, Mak J, Malekzadeh R, Mallinger L, Marcenes W, March L, Marks R, Martin R, McGale P, McGrath J, Mehta S, Mensah GA, Merriman TR, Micha R, Michaud C, Mishra V, Mohd Hanafiah K, Mokdad AA, Morawska L, Mozaffarian D, Murphy T, Naghavi M, Neal B, Nelson PK, Nolla JM, Norman R, Olives C, Omer SB, Orchard J, Osborne R, Ostro B, Page A, Pandey KD, Parry CD, Passmore E, Patra J, Pearce N, Pelizzari PM, Petzold M, Phillips MR, Pope D, Pope CA 3rd, Powles J, Rao M, Razavi H, Rehfuess EA, Rehm JT, Ritz B, Rivara FP, Roberts T, Robinson C, Rodriguez-Portales JA, Romieu I, Room R, Rosenfeld LC, Roy A, Rushton L, Salomon JA, Sampson U, Sanchez-Riera L, Sanman E, Sapkota A, Seedat S, Shi P, Shield K, Shivakoti R, Singh GM, Sleet DA, Smith E, Smith KR, Stapelberg NJ, Steenland K, Stöckl H, Stovner LJ, Straif K, Straney L, Thurston GD, Tran JH, Van Dingenen R, van Donkelaar A, Veerman JL, Vijayakumar L, Weintraub R, Weissman MM, White RA, Whiteford H, Wiersma ST, Wilkinson JD, Williams HC, Williams W, Wilson N, Woolf AD, Yip P, Zielinski JM, Lopez AD, Murray CJ, Ezzati M, AlMazroa MA, Memish ZA. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012 Dec 15;380(9859):2224-60.
Vos T, Lim SS, Abbafati C, et al.; GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020 Oct 17;396(10258):1204-22.
Meara JG, Leather AJM, Hagander L, Alkire BC, Alonso N, Ameh EA, Bickler SW, Conteh L, Dare AJ, Davies J, Mérisier ED, El-Halabi S, Farmer PE, Gawande A, Gillies R, Greenberg SL, Grimes CE, Gruen RL, Ismail EA, Kamara TB, Lavy C, Ganbold L, Mkandawire NC, Raykar NP, Riesel JN, Rodas E, Rose J, Roy N, Shrime MG, Sullivan R, Verguet S, Watters D, Weiser TG, Wilson IH, Yamey G, Yip W. Global Surgery 2030: Evidence and solutions for achieving health, welfare, and economic development. Surgery. 2015 Jul;158(1):3-6.
Ng-Kamstra JS, Riesel JN, Arya S, Weston B, Kreutzer T, Meara JG, Shrime MG. Surgical Non-governmental Organizations: Global Surgery’s Unknown Nonprofit Sector. World J Surg. 2016 Aug;40(8):1823-41.
Hendriks TCC, Botman M, Rahmee CNS, Ket JCF, Mullender MG, Gerretsen B, Nuwass EQ, Marck KW, Winters HAH. Impact of short-term reconstructive surgical missions: a systematic review. BMJ Glob Health. 2019 Apr 3;4(2):e001176.
Leversedge C, Castro S, Castro Appiani L, Kamal R, Shapiro L. Patient follow-up after orthopaedic outreach trips – do we know if patients are improving? World J Surg. 2022 Oct;46(10):2299-2309.
Beran D, Byass P, Gbakima A, Kahn K, Sankoh O, Tollman S, Witham M, Davies J. Research capacity building-obligations for global health partners. Lancet Glob Health. 2017 Jun;5(6):e567-8.
World Health Organization. WHO Global Initiative for Emergency and Essential Surgical Care (GIEESC). Accessed 2021 June 3. https://www.who.int/initiatives/who-global-initiative-for-emergency-and-essential-surgical-care#cms
Laxminarayan R, Mills AJ, Breman JG, Measham AR, Alleyne G, Claeson M, Jha P, Musgrove P, Chow J, Shahid-Salles S, Jamison DT. Advancement of global health: key messages from the Disease Control Priorities Project. Lancet. 2006 Apr 8;367(9517):1193-208.
Miclau T, MacKechnie MC, Born CT, MacKechnie MA, Dyer GSM, Yuan BJ, Dawson J, Lee C, Ishmael CR, Schreiber VM, Tejwani NC, Ulmer T, Shearer DW, Agarwal-Harding KJ, Johal H, Khormaee S, Sprague S, Whiting PS, Roberts HJ, Coughlin R, Gosselin R, Rosenwasser MP, Johnson A, Babu JM, Dworkin M, Makhni MC, McClellan T, Nwachuku CO, Miclau E, Morshed S. International Orthopaedic Volunteer Opportunities in Low and Middle-Income Countries. J Bone Joint Surg Am. 2022 May 18;104(10):e44.
Shapiro LM, Castro Appiani LM; GrUpo de estudio por extremidad Superior Traumatología y Orthopedico (GUSTO). Hand Surgery Outreach-From Short-Term “Missions” to Capacity Building. J Hand Surg. 2022 Oct;47(10):1005-1010.
Bardfield J, Palumbo M, Geis M, Jasmin M, Agins BD; NOA Working Group. A National Organizational Assessment (NOA) to Build Sustainable Quality Management Programs in Low- and Middle- Income Countries. Jt Comm J Qual Patient Saf. 2016 Jul;42(7):325-30.
HEALTHQUAL. National Organizational Quality Assessment Tool. Accessed 2022 May 16. https://healthqual.ucsf.edu/sites/g/files/tkssra931/f/HEALTHQUAL%20National%20Organizational%20Assessment_As%20of_3_2018.pdf
NSW Health Department. A Framework for Building Capacity to Improve Health. 2001. Accessed 2023 Apr 20. https://blogs.napier.ac.uk/docman/wp-content/uploads/sites/54/2020/01/What-is-capacity-building-A-framework-for-building-capacity-to-improve-health.pdf
Jick T. Mixing Qualitative and Quantitative Methods: Triangulation in Action. Qualitative Methodology. 1979;24(4):602-611.
Bekhet AK, Zauszniewski JA. Methodological triangulation: an approach to understanding data. Nurse Res. 2012;20(2):40-3.
Nwanna-Nzewunwa OC, Ajiko MM, Motwani G, Kabagenyi F, Carvalho M, Feldhaus I, Kirya F, Epodoi J, Dicker R, Juillard C. Identifying Information Gaps in a Surgical Capacity Assessment Tool for Developing Countries: A Methodological Triangulation Approach. World J Surg. 2019 May;43(5):1185-92.
Shapiro LM, Welch JM, Chatterjee M, Katarincic JA, Leversedge FJ, Dyer GSM, Fufa DT, Kozin SH, Chung KC, Fox PM, Chang J, Kamal RN. A Framework and Blueprint for Building Capacity in Global Orthopaedic Surgical Outreach. J Bone Joint Surg Am. 2023 Feb 1;105(3):e10.
Sykes KJ. Short-term medical service trips: a systematic review of the evidence. Am J Public Health. 2014 Jul;104(7):e38-48.
Lasker JN, Aldrink M, Balasubramaniam R, Caldron P, Compton B, Evert J, Loh LC, Prasad S, Siegel S. Guidelines for responsible short-term global health activities: developing common principles. Global Health. 2018 Feb 7;14(1):18.
AGREE-REX Research Team. AGREE-REX: Recommendation EXcellence. 2019. Accessed 2022 May. https://www.agreetrust.org/wp-content/uploads/2021/07/AGREE-REX-Tool-PDF-version.pdf
Brouwers MC, Spithoff K, Kerkvliet K, Alonso-Coello P, Burgers J, Cluzeau F, Férvers B, Graham I, Grimshaw J, Hanna S, Kastner M, Kho M, Qaseem A, Straus S, Florez ID. Development and Validation of a Tool to Assess the Quality of Clinical Practice Guideline Recommendations. JAMA Netw Open. 2020 May 1;3(5):e205535.
Babineau J. Product review: Covidence (systematic review software). Journal of the Canadian Health Libraries Association. 2014;35(2):68e71.
Leversedge C, McCullough M, Appiani LMC, Đình MP, Kamal RN, Shapiro LM. Capacity Building During Short-Term Surgical Outreach Trips: A Review of What Guidelines Exist. World J Surg. 2023 Jan;47(1):50-60.
Shapiro LM; Global Quality in Upper Extremity Surgery and Training (Global QUEST) Investigators. Quality Measures to Deliver Safe, High-Quality Care on Hand Surgery Outreach Trips to Low and Middle-Income Countries. J Bone Joint Surg Am. 2021 Apr 21;103(8):e32.
Shapiro LM; Global-Quest Investigators. Measuring and Improving the Quality of Care During Global Outreach Trips: A Primer for Safe and Sustainable Surgery. J Hand Surg Am. 2020 Sep;45(9):851-856.e2.
Søndergaard E, Ertmann RK, Reventlow S, Lykke K. Using a modified nominal group technique to develop general practice. BMC Fam Pract. 2018 Jul 18;19(1):117.
Harvey N, Holmes CA. Nominal group technique: an effective method for obtaining group consensus. Int J Nurs Pract. 2012 Apr;18(2):188-94.
ter Haar NM, Oswald M, Jeyaratnam J, Anton J, Barron KS, Brogan PA, Cantarini L, Galeotti C, Grateau G, Hentgen V, Hofer M, Kallinich T, Kone-Paut I, Lachmann HJ, Ozdogan H, Ozen S, Russo R, Simon A, Uziel Y, Wouters C, Feldman BM, Vastert SJ, Wulffraat NM, Benseler SM, Frenkel J, Gattorno M, Kuemmerle-Deschner JB. Recommendations for the management of autoinflammatory diseases. Ann Rheum Dis. 2015 Sep;74(9):1636-44.
McMillan SS, King M, Tully MP. How to use the nominal group and Delphi techniques. Int J Clin Pharm. 2016 Jun;38(3):655-62.
McMillan SS, Kelly F, Sav A, Kendall E, King MA, Whitty JA, Wheeler AJ. Consumers and Carers Versus Pharmacy Staff: Do Their Priorities for Australian Pharmacy Services Align? Patient. 2015 Oct;8(5):411-22.
Birt L, Scott S, Cavers D, Campbell C, Walter F. Member Checking: A Tool to Enhance Trustworthiness or Merely a Nod to Validation? Qual Health Res. 2016 Nov;26(13):1802-11.
Costello A, Zumla A. Moving to research partnerships in developing countries. BMJ. 2000 Sep 30;321(7264):827-9.
DeCorby-Watson K, Mensah G, Bergeron K, Abdi S, Rempel B, Manson H. Effectiveness of capacity building interventions relevant to public health practice: a systematic review. BMC Public Health. 2018 Jun 1;18(1):684.