Insight Into the Clinical Practices of US-Based Surgical Nongovernmental Organizations

• Published in: The Journal of surgical research 2024-09, Vol.301, p.578-583
• Main Authors: Johnston, Peter F., Bloom, Laura, Sifri, Ziad C.
• Format: Article
• Language: English
• Subjects: Global surgery; Humanitarian surgery; Nongovernmental organizations; Surgical missions
• ISSN: 0022-4804; 1095-8673; 1095-8673
• DOI: 10.1016/j.jss.2024.07.011

A growing sector of humanitarian surgical nongovernmental organizations (NGOs) is providing care in low- and middle-income countries. Minimal data exists regarding this extremely heterogeneous community. This study aims to describe the demographics and clinical practices of surgical NGOs. We hypothesize there are identifiable attributes of such organizations which correlate with success. A survey was sent to 83 US-based surgical NGOs directly providing general or subspecialty surgical care in low- and middle-income countries. Further information was obtained from organizations’ websites. Descriptive statistics were performed to analyze organizational attributes and define protocol-driven practices. Thirty NGOs (36%) responded, averaging 20 ± 11 y of operation. Annually, US humanitarian surgical organizations performed a wide range of operations (10-15,000) with 52% performing fewer than 200 operations per year. Sixty-seven percent of responders were classified as strongly protocol-driven. Only twenty percent reported deviation from standard US practice occurs often or very often, most commonly in pain management (18%), preoperative workup (16%), and operative technique (16%). To our knowledge, this is the first effort to describe the characteristics and clinical practices of the humanitarian surgical sector. There exists a wide scope of clinical practice among responding surgical NGOs, however mostly consistent with US standards, with a prevalance of protocol-driven clinical approach. Developing consensus-based protocols may help standardize and improve quality of care for surgical NGOs. •Survey of practices/characteristics of US-based humanitarian surgical organizations.•Diverse scope and breadth of practice between organizations within the humanitarian surgical sector.•Organizations report infrequent or inconsequential variation from US standard practices.•Most organizations abide by protocol-driven practices, which correlate with their longevity and impact.