Joseph A. Dearani, MD, Jeffrey P. Jacobs, MD, R

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Presentation transcript:

Humanitarian Outreach in Cardiothoracic Surgery: From Setup to Sustainability Joseph A. Dearani, MD, Jeffrey P. Jacobs, MD, R. Morton Bolman, MD, JaBaris D. Swain, MD, PhD, Luca A. Vricella, MD, Samuel Weinstein, MD, Emily A. Farkas, MD, John H. Calhoon, MD The Annals of Thoracic Surgery Volume 102, Issue 3, Pages 1004-1011 (September 2016) DOI: 10.1016/j.athoracsur.2016.03.062 Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Diagnostic approach to the management of complex change. Successful change occurs when there is a vision, appropriate skill sets, incentives, resources, and an action plan. (Data from Ambrose D. Managing complex change. Pittsburgh: The Enterprise Group Ltd, 1987.) The Annals of Thoracic Surgery 2016 102, 1004-1011DOI: (10.1016/j.athoracsur.2016.03.062) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Relationships between the constructs of awareness, access, and affordability, and their influence on medical factors and system outcome. These relationships are subsumed by the influence of other environmental factors, generally outside the control of the organizations composing the health care supply chain [3]. The Annals of Thoracic Surgery 2016 102, 1004-1011DOI: (10.1016/j.athoracsur.2016.03.062) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Cardiac surgical patient volume at the First Hospital of Lanzhou University over a 5-year period. Early mortality decreased from approximately 10% to 3%, while there was an increased number of more complex cases (ie, Risk Adjusted Classification for Congenital Heart Surgery-1 categories 3, 4, and 5 in the latter years) [3]. (Black bars = total surgical patients; white bars = pediatric surgical patients.) The Annals of Thoracic Surgery 2016 102, 1004-1011DOI: (10.1016/j.athoracsur.2016.03.062) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Mortality for pediatric cardiac surgical procedures: Tomsk, 2006–2012. Note marked decrease in operative morality over time in conjunction with a progressively higher level of case complexity [7]. (Gray bars = pediatric cardiac surgical procedures only; red bars = pediatric cardiac surgical procedures and interventional catheterizations.) The Annals of Thoracic Surgery 2016 102, 1004-1011DOI: (10.1016/j.athoracsur.2016.03.062) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions