Short Term Surgical Mission Evaluation: A Medical Record Analysis

AbstractBackground: Oral clefts occur in approximately one out of 700 births worldwideand can affect the lip, the palate, or both. In developing countries, lack of awarenessof cleft treatment options, scarcity of surgical services, and poverty create barriersto corrective surgeries. To reduce global cleft care disparities, manynongovernmental organizations have developed short-term missions that providesurgical treatment. Few of these organizations have evaluated the impacts of theirprograms for the children and their families.Aim: To evaluate the activities of the surgical outreach organization Faces of Hope(FOH) for the years 2005 through 2009.Conceptual Framework: The Center for Disease Control Framework for ProgramDevelopment in Public Health was used to initiate the evaluation of FOH. Researchquestions evaluated patient eligibility to receive services, and the outputs andoutcomes of the services provided.Design: A cross sectional design utilizing five consecutive years of data collected forclinical purposes.Methods: Medical record review data provided the independent, dependent andcovariate variables.Sample: A sample of 706 medical records documented the clinical encounters ofGuatemalan families seeking surgical services from the organization FOH for 2005to 2009.vResults: There is no evidence that surgical repair of primary orofacial cleftsoccurred sooner over the years of FOH activities. Surgical complications comparedby years suggest that a statistically significant difference exists between surgicalcomplications in 2006 and 2009. There were no complications in 2009 compared to2006 in which there was an 11.3% complication rate. Anesthetic complications didnot have an association by year. Diagnosis, illness and wt/age- in- month Z scoreswere statistically significant predictors of complications.Eligibility (receiving surgical treatment) was predicted by previous surgery, illnessand diagnosis. Pre-operative vital signs and blood hemoglobin level did not predicteligibility. Returning in subsequent years to seek additional services was predictedby diagnosis, wt/age-in-month Z scores and documented futures needs.Significance: Evaluation of short-term surgical missions is crucial as theseorganizations continue to participate in the provision of surgical care for childrenwho may otherwise not receive treatment