Dearani Joseph A, Neirotti Rodolfo, Kohnke Emily J, Sinha Kingshuk K, Cabalka Allison K, Barnes Roxann D, Jacobs Jeffrey P, Stellin Giovanni, Tchervenkov Christo I, Cushing John C
Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2010;13(1):35-43. doi: 10.1053/j.pcsu.2010.02.001.
This article reviews a systematic approach to the design and support of pediatric cardiac surgery programs in the developing world with the guidance and strategies of Children's HeartLink, an experienced non-government organization for more than 40 years. An algorithm with criteria for the selection of a partner site is outlined. A comprehensive education strategy from the physician to the allied health care provider is the mainstay for successful program development. In a partner program, the road to successful advancement and change depends on many factors, such as government support, hospital administration support, medical staff leadership, and a committed and motivated faculty with requisite skills, incentives, and resources. In addition to these factors, it is essential that the development effort includes considerations of environment (eg, governmental support, regulatory environment, and social structure) and health system (elements related to affordability, access, and awareness of care) that impact success. Partner programs should be willing to initiate a clinical database with the intent to analyze and critique their results to optimize quality assurance and improve outcomes.
本文回顾了在儿童心脏连接组织(一个拥有40多年经验的非政府组织)的指导和策略下,为发展中国家的小儿心脏外科项目设计与提供支持的系统方法。文中概述了一个用于选择合作站点的标准算法。从医生到专职医护人员的全面教育策略是项目成功发展的支柱。在合作项目中,成功推进与变革的道路取决于许多因素,如政府支持、医院管理支持、医务人员领导力,以及一支具备必要技能、激励措施和资源且敬业且积极进取的教职员工队伍。除这些因素外,发展工作必须考虑影响成功的环境(如政府支持、监管环境和社会结构)和卫生系统(与医疗可负担性、可及性及医疗意识相关的要素)。合作项目应愿意启动临床数据库,旨在分析和评估其结果,以优化质量保证并改善治疗效果。