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Global Surgery: Progress and Challenges in Surgical Quality and Patient Safety

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Surgical Patient Care

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Abstract

Provision of high-quality surgical care is a prerequisite of all health systems worldwide. Although globally low- and middle-income countries (LMICs) bear the greatest burden of surgical disease, accessing high-quality surgical care in LMICs remains a major challenge due to severe limitations in infrastructure at multiple levels. Further challenges exist around issues of appropriate staffing, and a lack of funding which remains the largest hurdle for the majority of LMICs. Given these challenges, LMICs do not have the resources to implement international, well-validated programs and health care guidelines to ensure safe surgical care. The degree to which unsafe care is a problem for developing countries is not well known although the WHO estimates unsafe surgical care in LMICs are a leading cause of morbidity and mortality worldwide.

The engagement of international organizations has been a welcome boost for many patients in LMICs, but long-term sustainable strategies are required to meet spiralling health needs and generic efforts or guidelines have proven to be inadequate. Effective interventions in these resource-poor settings must be low-cost and targeted to local needs to improve capacity, infrastructure, and ability to access safe and high-quality surgical care in a timely and affordable way.

“Of all the forms of inequality, injustice in health care is the most shocking and inhumane.”

—Dr. Martin Luther King, Jr.

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Authors and Affiliations

  1. Imperial College Healthcare NHS Trust, Department of Surgery and Cancer, St. Mary’s Hospitalm, Praed Street, London, W2 1NY, UK

    Christopher Pettengell BMBCh, MA (oxon), MRCS, Stephen Williams BMBCh, MA (oxon), MRCS & Ara Darzi FRS, FMedSci, HonFREng

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  1. Christopher Pettengell BMBCh, MA (oxon), MRCS
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  2. Stephen Williams BMBCh, MA (oxon), MRCS
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  3. Ara Darzi FRS, FMedSci, HonFREng
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Correspondence to Ara Darzi FRS, FMedSci, HonFREng .

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Editors and Affiliations

  1. Department of Surgery Ascension Saint Agnes Hospital Armstrong Institute for Patient Safety & Quality, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Juan A. Sanchez

  2. Children’s Cardiomyopathy Foundation and Kyle John Rymiszewski Research Scholar, Children’s Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI, USA

    Paul Barach

  3. Department of Surgery Center for Healthcare Studies Institute for Public Health and Medicine Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Julie K. Johnson

  4. Division of Cardiovascular Surgery Johns Hopkins All Children’s Heart Institute Johns Hopkins All Children’s Hospital, Johns Hopkins University, Saint Petersburg, FL, USA

    Jeffrey P. Jacobs

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Pettengell, C., Williams, S., Darzi, A. (2017). Global Surgery: Progress and Challenges in Surgical Quality and Patient Safety. In: Sanchez, J., Barach, P., Johnson, J., Jacobs, J. (eds) Surgical Patient Care. Springer, Cham. https://doi.org/10.1007/978-3-319-44010-1_50

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