Tackling Anesthesia, Surgical Needs: A discussion with Ann Hau

Many patients in rural areas and in the developing world are not able to receive life-saving surgeries because of the lack of surgeons, anesthesiologists, or medical officers with basic surgical and anesthesiology training.

Initiatives like the WHO Safe Surgery Saves Lives Checklist are proving very useful. The 19-item checklist, an effort led by Dr. Atul Gawande, has thus far demonstrated efficacy in reducing the complications and mortality associated with a variety of surgical procedures by more than 30% by facilitating essential communication among all members of the operative team. But some suggest that in health facilities where leaders and supervisors pushed the use of the checklist without getting first buy-in, “even a year into implementation, providers (doctors, nurses, and techs) do not use it in the manner intended and it has become just another burdensome form to be completed.” There are many efforts like these, but once again better coordination and open collaboration between actors is sorely needed.

A home in the rain forest in Costa Rica, where Dr. Hau had a first glimpse of medicine in underserved areas visiting rural health facilities with a medical Spanish program.

I recently met with Ann Hau, MD, an anesthesiology resident at Beth Israel Deaconess Medical Center in Boston, U.S. (BIDMC) and a co-moderator of the Global Surgery & Anesthesia community on GHDonline with Robert Riviello, MD, MPH, Brigham And Women’s Hospital also in Boston; Lubna Samad, MD, Indus Hospital, Pakistan; and Nadine Semer, MD, American College of Surgeons.

During our discussion, Ann talked about her inspiration and work, future projects, and her hopes that the community will connect people and help answer questions, and bring a better understanding of the issues that members face on the ground.

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Disparities in Surgical Care: Research to Practice – 2nd Symposium

Keynote Speakers:
- Haile T. Debas, M.D.
- The Honorable Louis W. Sullivan, M.D., M.A.C.P.
- John L. Tarpley, M.D., F.A.C.S., F.W.A.C.S.

Offered by: The Center for Surgery and Public Health at Brigham and Women’s Hospital, Harvard Medical School

Location: Seaport World Trade Center Boston, Boston, Massachusetts, U.S.A

Although disparities in surgical care have been documented, few attempts have been made to systematically study and understand the complex determinants of these disparities. Moreover, few studies have valuated interventions to eliminate disparities in surgical care. We need to develop, implement, and evaluate
strategic changes in our health care systems, our patients, and ourselves to eliminate disparities in access to surgical services, as well as the outcomes of surgical care.

Given the complexity of these issues, this unique course provides an opportunity for a broad based coalition of clinicians, policy makers, advocates, and other stakeholders to put forward multi-pronged approaches to the elimination of surgical disparities. The focus of this symposium is to translate research to practice. Because surgical disparities are not limited to populations in the United States, the global problem of disparities in surgery and its unique challenges will be addressed, including presentations of case studies from the developing world.

Constrained resources, systems of care, quality of surgical care, and surgical safety all impact the delivery of surgical care and often effect disparate outcomes. These facets will be explored in greater depth. The role of academic medical centers in surgical delivery, issues of workforce development and human capital, the impact of health care reform with Massachusetts as a model, the importance of data collection of race/ethnicity and primary language, and community participatory interventions as they impact these disparities will also be addressed.

In this second symposium, we aim to build on the momentum and energy of the first meeting and continue to seek to understand the nature of disparities in surgical care and the factors that influence and mitigate them. To that end, this course is structured to have multiple opportunities for formal and informal interaction with faculty and will foster networking and collaboration.

Links to Register or download a course brochure; For More Information, please contact Bridget Craig with any questions about the symposium at 617-525-7300 or bmcraig[at]partners.org.