Task Sharing in Global Cardiac Surgery: A Scoping Review.

BACKGROUND

Access to cardiac surgical services is limited in low- and middle-income countries. The shortage of cardiac surgical care providers is a major contributor to this limited access to lifesaving care. Task shifting and task sharing allow nonspecialists to perform roles typically reserved for specialists such as cardiothoracic surgeons, cardiac anesthesiologists, and other health care workers with specific training in cardiac surgical care. Task sharing has increased access to care without compromising outcomes in related surgical fields, such as general surgery, orthopedic surgery, neurologic surgery, and obstetrics and gynecologic surgery.

METHODS

A scoping review was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews using the databases PubMed/MEDLINE, Embase, World Health Organization Global Index Medicus, and Web of Science. The search was constructed to identify articles specifically addressing task sharing in cardiac surgical care.

RESULTS

Four relevant articles were identified. Only 1 focused on task sharing specifically by cardiac surgeons; this was a case study of 2 surgeons at a single hospital who used task sharing with junior surgeons to varying degrees. Two studies discussed task sharing as part of a team-based approach to the management of rheumatic heart disease; 1 study discussed cost-effectiveness in the delivery of cardiac surgical care and included task sharing as 1 approach to cost reduction.

CONCLUSIONS

There is a paucity of literature describing the applications and outcomes of task sharing in cardiac surgery in variable-resource contexts. Here, we present a scoping review summarizing the literature on experiences with task sharing for cardiac surgical care.