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RACS ASC 2024

Scaling Surgical Resources: A Baseline Capacity Analysis of Orthopedic Surgical Care and C-arm Machines in Haiti

Poster

Presentation Description

Institution: Harvard Medical School - Boston/MA, United States of America

Purpose: In August 2021, a 7.2 magnitude earthquake struck Haiti resulting in a surge of orthopedic trauma. Safe and efficient operative management of orthopedic trauma injuries requires intra-operative fluoroscopy (C-arm machines). Peri-earthquake, Haiti Health Network (HHN) identified only three operational C-arms machines. The study objective was to perform a baseline capacity analysis (BCA) of the twelve HHN hospitals, through determining (1) Clinical Need: orthopedic trauma operative caseload requiring C-arm and (2) Hospital Readiness: ability to operate and maintain this equipment. Methodology: Twelve hospitals' senior surgeon or hospital administrator completed a BCA survey, including free text, multiple choice and scale questions classified into five categories: staff, space, stuff, systems and surgical capacity. Data assessors were blinded throughout the analysis. Each hospital received a final score, which was calculated by weighting each of the five categories equally. Results: Ten hospitals completed the survey, with three reporting functional C-arm machines and two with non-functional C-arm machines. The mean score was 60.74 (IQR 47.4-70.6; STD 18.91). The median number of full-time orthopedic surgeons was 2.5 (IQR 2.5-3; STD 0.886), 24 (IQR 22.6-55; STD 64.56) orthopedic trauma operations were conducted per month, of which 22 (IQR 7-24; STD 21.62) operations required intra-operative fluoroscopy. Conclusion: The survey results confirmed the need for more C-arms in Haitian hospitals and identified the hospitals with sufficient capabilities to receive this equipment. Recommendations were provided to philanthropic groups to provide additional equipment to benefit the local community.

Speakers

Authors

Authors

Dr Helena Franco - , Dr Abdoulie Njai - , Dr Sam Simister - , A/Prof Pierre Woolley - , A/Prof Michelle Joseph -