Background: Surgical pathology comprises a large portion of the global burden of disease - disproportionately affecting low- and middle-income countries (LMICs). As LMICs currently lack the healthcare infrastructure, healthcare personnel, and training to handle this caseload, an unknown amount of surgery is performed by international organizations. Despite this, there is a paucity of data regarding the quality of care provided by these groups. The Emory University School of Medicine and Project Medishare (EUSOM-PM) surgery trip attempts to increase access to surgical services in the Central Plateau of Haiti, but has yet to establish a system to assess the quality of care provided to patients.
Objective: The goal of this thesis is to define indicators of surgical quality applicable to a low-resource setting and to establish reliable data collection techniques for the EUSOM-PM surgery trip. Methods: Indicators of surgical quality validated in the United States that were transferable to a low-resource setting were included in a data collection instrument. The instrument was used to gather information regarding structural, process, and outcome elements of patient care Results: Quantitative data collected using the data instrument had high response rates and provided complete information regarding patient demographics, processes of care, and outcomes.
Conclusions: A standardized data collection instrument results in more complete data regarding the patient population and the quality of care provided. However, the small quantity of data, particularly the low rates of adverse postoperative outcomes, limits any conclusions regarding the validity of indicators. Continued use of the data instrument will allow for the generation of a multi-year aggregated data set, providing information about shifts in patient demographics, reflect alterations in care processes, and potentially, the impact of these factors on patient outcomes.