Background: High rates of orthopaedic injury in Uganda place large burdens on its few orthopaedic surgeons. Although “task-shifting” of procedures to other providers is practiced, its specific role in orthopaedic surgical care is not well documented. The current study assessed the prevalence of orthopaedic task-shifting, and its impact on time-to-surgery, at the Mbarara Regional Referral Hospital (MRRH) in Western Uganda. Methods: A retrospective cohort study was conducted. All orthopaedic cases recorded in the MRRH operating theatre logbook were analyzed (October 2018 to July 2019). Surgical indication, type of procedure, and operator were recorded. Permanent hospital records, when available, were used to verify logbook data and identify the initial date of hospital admission for each patient. Results: There were 203 patients who received orthopaedic surgery during the study period, with 159 having hospital admission dates. The single orthopaedist at MRRH performed the majority of orthopaedic procedures (61.6% of cases). Significant task-shifting was seen, both to other physicians (33% of cases) and orthopedic clinical officers (5.4%). The orthopaedist performed most hardware implantation procedures (80.8%), while other practitioners performed the majority of trauma cases, particularly conservative fracture management (92.7%). Overall, the average time from admission to surgery was longer for orthopaedists (11.2 days) than for other providers (4.2 days, p<0.001). Conclusions: The current study demonstrates high utilization of orthopaedic task-shifting, and its associated decreased time-to-surgery, at MRRH. This reinforces the role of task-shifting in resource-limited settings. Furthermore, it highlights the importance of continued training of non-orthopaedic providers in foundational orthopaedic surgical principles.
| Published in | European Journal of Clinical and Biomedical Sciences (Volume 7, Issue 6) |
| DOI | 10.11648/j.ejcbs.20210706.14 |
| Page(s) | 111-117 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2021. Published by Science Publishing Group |
Global Surgery, Orthopedics, Outcomes, Rural, Trauma
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APA Style
Michael Flores, Daniel Kisitu, Connor Peck, Michael Amick, Kristin Yu, et al. (2021). Orthopaedic Surgical Task-Shifting and Its Impact on Time-to-Surgery in Western Uganda. European Journal of Clinical and Biomedical Sciences, 7(6), 111-117. https://doi.org/10.11648/j.ejcbs.20210706.14
ACS Style
Michael Flores; Daniel Kisitu; Connor Peck; Michael Amick; Kristin Yu, et al. Orthopaedic Surgical Task-Shifting and Its Impact on Time-to-Surgery in Western Uganda. Eur. J. Clin. Biomed. Sci. 2021, 7(6), 111-117. doi: 10.11648/j.ejcbs.20210706.14
AMA Style
Michael Flores, Daniel Kisitu, Connor Peck, Michael Amick, Kristin Yu, et al. Orthopaedic Surgical Task-Shifting and Its Impact on Time-to-Surgery in Western Uganda. Eur J Clin Biomed Sci. 2021;7(6):111-117. doi: 10.11648/j.ejcbs.20210706.14
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Download@article{10.11648/j.ejcbs.20210706.14,
author = {Michael Flores and Daniel Kisitu and Connor Peck and Michael Amick and Kristin Yu and Adrienne Socci},
title = {Orthopaedic Surgical Task-Shifting and Its Impact on Time-to-Surgery in Western Uganda},
journal = {European Journal of Clinical and Biomedical Sciences},
volume = {7},
number = {6},
pages = {111-117},
doi = {10.11648/j.ejcbs.20210706.14},
url = {https://doi.org/10.11648/j.ejcbs.20210706.14},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ejcbs.20210706.14},
abstract = {Background: High rates of orthopaedic injury in Uganda place large burdens on its few orthopaedic surgeons. Although “task-shifting” of procedures to other providers is practiced, its specific role in orthopaedic surgical care is not well documented. The current study assessed the prevalence of orthopaedic task-shifting, and its impact on time-to-surgery, at the Mbarara Regional Referral Hospital (MRRH) in Western Uganda. Methods: A retrospective cohort study was conducted. All orthopaedic cases recorded in the MRRH operating theatre logbook were analyzed (October 2018 to July 2019). Surgical indication, type of procedure, and operator were recorded. Permanent hospital records, when available, were used to verify logbook data and identify the initial date of hospital admission for each patient. Results: There were 203 patients who received orthopaedic surgery during the study period, with 159 having hospital admission dates. The single orthopaedist at MRRH performed the majority of orthopaedic procedures (61.6% of cases). Significant task-shifting was seen, both to other physicians (33% of cases) and orthopedic clinical officers (5.4%). The orthopaedist performed most hardware implantation procedures (80.8%), while other practitioners performed the majority of trauma cases, particularly conservative fracture management (92.7%). Overall, the average time from admission to surgery was longer for orthopaedists (11.2 days) than for other providers (4.2 days, p<0.001). Conclusions: The current study demonstrates high utilization of orthopaedic task-shifting, and its associated decreased time-to-surgery, at MRRH. This reinforces the role of task-shifting in resource-limited settings. Furthermore, it highlights the importance of continued training of non-orthopaedic providers in foundational orthopaedic surgical principles.},
year = {2021}
}
TY - JOUR T1 - Orthopaedic Surgical Task-Shifting and Its Impact on Time-to-Surgery in Western Uganda AU - Michael Flores AU - Daniel Kisitu AU - Connor Peck AU - Michael Amick AU - Kristin Yu AU - Adrienne Socci Y1 - 2021/11/24 PY - 2021 N1 - https://doi.org/10.11648/j.ejcbs.20210706.14 DO - 10.11648/j.ejcbs.20210706.14 T2 - European Journal of Clinical and Biomedical Sciences JF - European Journal of Clinical and Biomedical Sciences JO - European Journal of Clinical and Biomedical Sciences SP - 111 EP - 117 PB - Science Publishing Group SN - 2575-5005 UR - https://doi.org/10.11648/j.ejcbs.20210706.14 AB - Background: High rates of orthopaedic injury in Uganda place large burdens on its few orthopaedic surgeons. Although “task-shifting” of procedures to other providers is practiced, its specific role in orthopaedic surgical care is not well documented. The current study assessed the prevalence of orthopaedic task-shifting, and its impact on time-to-surgery, at the Mbarara Regional Referral Hospital (MRRH) in Western Uganda. Methods: A retrospective cohort study was conducted. All orthopaedic cases recorded in the MRRH operating theatre logbook were analyzed (October 2018 to July 2019). Surgical indication, type of procedure, and operator were recorded. Permanent hospital records, when available, were used to verify logbook data and identify the initial date of hospital admission for each patient. Results: There were 203 patients who received orthopaedic surgery during the study period, with 159 having hospital admission dates. The single orthopaedist at MRRH performed the majority of orthopaedic procedures (61.6% of cases). Significant task-shifting was seen, both to other physicians (33% of cases) and orthopedic clinical officers (5.4%). The orthopaedist performed most hardware implantation procedures (80.8%), while other practitioners performed the majority of trauma cases, particularly conservative fracture management (92.7%). Overall, the average time from admission to surgery was longer for orthopaedists (11.2 days) than for other providers (4.2 days, p<0.001). Conclusions: The current study demonstrates high utilization of orthopaedic task-shifting, and its associated decreased time-to-surgery, at MRRH. This reinforces the role of task-shifting in resource-limited settings. Furthermore, it highlights the importance of continued training of non-orthopaedic providers in foundational orthopaedic surgical principles. VL - 7 IS - 6 ER -
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