Project Hippo

Hernias, Pathway and Planetary Outcomes for Inguinal Hernia Surgery

Our aim is to:

  1. Characterise the global backlog for elective surgery
  2. Technique, training and operating surgeon variation
  3. Explore environmentally sustainable practices in operating theatres

Please click below to access the documents:

Study protocol: here.

Case report form: here.

Patient information sheet: here.

Patients consent form (adults): here. 

Children consent form: here 

You can register your interest here.

0

CONTINENTS

0

COUNTRIES

0

HOSPITALS

0

PATIENTS RECRUITED

GSU Case Study Burns
GSU-Studies-Access-1

HIPPO National Leads

You can message the Country Lead(s) by clicking on the country name that you are based in below:

Region Country First Name Last Name
Europe Albania Irida Dajti
Austria Felix Aigner
Belgium Frederik Berrevoet
Bosnia and Herzegovina Samir Delibegovic
Bulgaria Mihail Slavchev
Croatia Jakov Mihanovic
Cyprus Anneza Yiallourou
Czech Republic Barbora East
Ethiopia Alazar Berhe
France Alexis Arnaud
Germany Hans Lederhuber
Greece Ioannis Katsaros
George Tsoulfas
Ireland Sinead Ramjit
Italy Francesco Pata
Gaetano Gallo
Lithuania Aiste Gulla
Portugal Mafalda Alves
Irene Santos
Guilherme Nobre
Romania Ionut Negoi
Slovenia Jurij Kosir
Spain Ana Minaya Bravo
Switzerland Eleftherios Gialamas
Africa Benin Ismael Lawani
Burkina Faso Aimee Florence Sanou
Adama Sanou
Burundi Mbonicura Jean Claude
Alliance Niyukuri
Cameroon Olivier Gabom
Chukwuemeka Nwegbu
Aristide Bang
Egypt Sameh Emile
Gabon Natacha Boumas
Ghana Eseenam Abgeko
Stephen Tabiri
Kenya Intisar Hisham
Liberia Elvis Mbanzabugabo
Muhammed Elhadi
Madagascar Luc Samison
Malawi Raymond Nyirenda
Mulinda Nyirenda
Mali Bréhima Bengaly
Namibia Rashid Nashidengo Nashidengo
Niger Adakal Ousseini
Nigeria Adesoji Adewumiya
Wale Adisa
Rwanda Faustin Ntirenganya
Sierra Leone Ibrahim Fortune
South Africa Rachel Moore
Kathryn Chu
Sudan Mohammed Elmujtaba
Tanzania Mugisha Nkoronko
Uganda Isaac Mubezi
Americas Argentina Martin Lucchini
Manuel Palacios
Canada Amanpreet Brar
Janet Martin
Chile Maria Marta Modolo
Maricarmen Olivos
Colombia Jose Andres Calvache
Dominican Republic Silvia Batista
Ruben Rivas
Ecuador Eddy Lincargo
Paraguay Hugo Gomez
United States Josh Ngkamstra
Venezuela Osama Bahsas Zaky
China, SE Asia & Pacific Australia Amanda Dawson
Malaysia April Roslani
New Zealand Matt McGuinness
Debora Wright
Philippines Marie Dione Parreno-Sacdalan
Jose Macario Faylona
Asia
Georgia Zaza Demetrashvili
India Dhruva Ghosh
Parvez Haque
Atul Suroy
Lovenish Bains
Jyoti Dhima
Israel Gadi Marom
Jordan Faris Ayasra
Kazakhstan Ildar R Fakhradiyev
Kyrgyzstan Ayesha Iqbal

Bringing together surgeons, researchers and policy makers to set the local research agenda according to patient need in LMIC and ensuring all patients have the opportunity to take part in our research.


Nursing Network

Outcome of surgery is not dependent solely on surgeons skills but on the completeness of the Surgical Nursing competence & compassionate care.

The global nursing workforce is made up of approximately 27.9 million men and women, accounting for almost 50% of the global health workforce.

Our goal is to strengthen the contribution of this skilled workforce in:

  1. Delivering optimum perioperative care to improve surgical outcomes for patients
  2. Building nursing research and research management capacity through education and training for nurses to facilitate collaborative work with existing GlobalSurg teams
  3. Building a global consensus on the nurse priorities for perioperative research
  4. Building capacity and capability to advance the perioperative nurse workforce with a focus on LMICs
  5. Working in collaboration with the Edinburgh Global Nursing Initiative | The University of Edinburgh https://www.ed.ac.uk/health/subject-areas/nursing-studies/global-initiative

For any associated queries, please contact Sangeetha Samuel (Project Co-Lead) sangeetha.samuel@cmcludhiana.in

“We are currently assembling the information for this page which will be published soon.  Thank you for your patience and please visit us again soon to see the update information.”

0

CONTINENTS

0

COUNTRIES

0

HOSPITALS

0

PATIENTS RECRUITED

GSU Case Study Burns
GSU-Studies-Access-1

Bringing together surgeons, researchers and policy makers to set the local research agenda according to patient need in LMIC and ensuring all patients have the opportunity to take part in our research.


Project Panda

PANDA Overview

PANDA seeks to use qualitative methods to understand what matters to patients in their receipt of surgical care, to prioritise these themes, and explore differences across countries and contexts. Design and delivery of PANDA will be informed by patient and community representatives, with the explicit aim of growing networks for local community involvement in LMICs. Use of qualitative methodology to explore patients experiences of surgical treatment in depth in this study will have several advantages.

Firstly, it will allow deep conceptual understanding of patient’s priorities during their surgical care journeys. Whilst each patient will have their own unique care story, there are likely to be commonalities to patient experience which could underpin patient-centred design for large, multi-country research studies. Secondly, working with patients and community representatives to co-produce and prioritise themes will help improve capacity and leadership for CEI in low-resource settings. Thirdly, through talking to patients about research topics in depth we will improve ‘research literacy’ amongst local populations, and help to identify new patient partners for research involvement in global surgery.

Through co-production of the PANDA study between patients, community members and research team members in LMICs, the key principles of sharing power, building relationships, diverse perspectives, respect and reciprocity for successful CEI will be upheld.

Research exploring patients experiences of surgical care has predominantly focussed on the preoperative setting (i.e., access to care). Qualitative studies of the perioperative care pathway have focussed on providers resilience to resource shortfalls, system level factors impacting on care delivery, and preoperative optimisation checklists. Few studies have focussed on patient priorities for their surgical care, and none in LMICs. In a study with a similar methodology in Sweden (high income) four areas were highlighted including accessibility, reliability, caring attitudes and empowerment.

For patients undergoing head and neck cancer surgery in an Australian hospital (high-income), psychological support for ‘shocks and aftershocks’ was prioritised as a key research area. There is an urgent need to understand patients experiences and priorities for surgical care in LMICs to inform future research planning and design.

You can view further information on the study via the recently created PowerPoint presentation.

0

CONTINENTS

0

COUNTRIES

0

HOSPITALS

0

PATIENTS RECRUITED

PANDA Aims

  • To explore and describe patients experience of perioperative care pathways in LMICs
  • To identify and prioritise concepts and themes for research in global surgery with patients in LMICs
  • To explore the feasibility of flexible, collaborative co-production of research between LMIC researchers, patients and UK researchers in global surgery.
  • To build capacity for CEI through identifying, training and involving patients and community members in the PANDA study.

Key Documents

PANDA Protocol can be obtained here

PANDA Patient Consent form can be accessed here

PANDA Patient Information sheet can be accessed here

PANDA topic guide can be accessed here

GSU Case Study Burns
GSU-Studies-Access-1

GSU Case Study Burns

Project Burns

GSU Case Study Burns

Burns are a significant contributor to the burden of disease in low- and middle-income countries (LMIC). Although current guidelines recommend treatment in specialized treatment centres, such centres are few or non-existent in many LMIC settings.

This study is a prospective observational study comparing outcomes of burns treatments between non-specialised and specialised burns units.

Led by Dr Chikwendu Ede and Dr Rachel Moore from the NIHR Global Surgery Unit hub in South Africa, this is a prospective observational study comparing outcomes of burns treatments between non-specialised and specialised burns units. Information on 90 day mortality will be collected over a 6 month period at up to 9 non-specialised hospitals treating adult burns patients and compared to outcomes for patients at a dedicated burns unit at Chris Hani Baragwanarth Academic Hospital in Soweto, Johannesburg.

Burns Victim

“We are currently assembling the information for this page which will be published soon.  Thank you for your patience and please visit us again soon to see the updated information.”

GSU Case Study Burns
GSU-Studies-Access-1

GSU-Studies-Access-1

Project Access

GSU-Studies-Access-1

The majority of the world’s population lack access to timely hospital care. In low & middle income countries, 98% of patients lack access to safe, affordable surgical care.

Those that do reach hospital often experience delays in their care, contributing to the observed increased death rates in LMICs.

Our Access to Surgical Care project is surveying patients, policy makers and healthcare providers to identify the barriers and potential solutions in order to improve access to surgical care for patients in LMICs.

“We are currently assembling the information for this page which will be published soon.  Thank you for your patience and please visit us again soon to see the update information.”

0

CONTINENTS

0

COUNTRIES

0

HOSPITALS

0

PATIENTS RECRUITED

GSU Case Study Burns
GSU-Studies-Access-1

Bringing together surgeons, researchers and policy makers to set the local research agenda according to patient need in LMIC and ensuring all patients have the opportunity to take part in our research.


GSU-GlobalSurge3

Global Surg 3

About GlobalSurg 3

GlobalSurg 3 is a multicentre international study determining quality and outcomes in global cancer surgery for breast, gastric and colorectal cancer. Any hospital performing surgery for breast, gastric, or colorectal cancer anywhere in the world is eligible to take part. Across centres worldwide, mini-teams of up to 3 collaborators will collect data for a four-week period between April and October 2018, with a 30 day follow up.

GlobalSurg 3 aimed to determine the variation in quality of cancer care surgery worldwide. The study concentrated on the most surgically-treated cancers worldwide: breast, gastric and colorectal cancer.’

Validating data is important in ensuring that the results obtained for the study are of high quality. The aim is to achieve this by assessing the methods used for patient identification, data collection and patient follow up. The process itself will involve three parts:

A. Patient identification and follow up

B. Independent Validation

C. National Lead and Hub Country Interview

 

GSU Case Study Burns
GSU-Studies-Access-1

GSU-GlobalSurge2

Global Surg 2

About GlobalSurg 2

GlobalSurg 2 aimed to determine worldwide surgical site infection (SSI) rates following gastrointestinal surgery. The primary outcome measure for the study was 30 day surgical site infection rate.

Teams of 3 collaborators collected data for two week periods on all consecutive (i.e. one after the other) patients undergoing elective or emergency gastrointestinal surgery. There was no minimum number of patients per centre, so long as all eligible patients during the two week data collection period were included. Teams could collect any two week period they wished between Jan and July 2016, with 30 day follow up. Multiple teams at any participating centre were encouraged provided they collected non-overlapping two-week periods, and each team could collect one than one two week period if they wished.30 datapoints per patient were collected via a secure online website.

12,539

PATIENTS

343

HOSPITALS

66

COUNTRIES

View the GlobalSurg 1 results in a snapshot

Globalsurg Two Infographic
Studies- GSU - Crocodile
Studies- GSU - Tiger
Studies- GSU - Lion
GSU-GlobalSurge2
Studies- GSU - Kiwi
CEI Case Study - Starfish

GSU-GlobalSurge1

Global Surg 1

About GlobalSurg 1

GlobalSurg I aimed to identify variation in outcome of emergency intra-abdominal surgery across international settings in order to determine whether globally relevant quality improvement strategies are needed within acute surgical units.

The study ran from July to November 2014. Contributors collected data on consecutive patients undergoing emergency  intra-peritoneal surgery (excluding Caesarean section) over a two-week period in their local centres.

Patients were reviewed 24-hours post-surgery to determine whether they are dead or alive and any in-hospital complications by 30-days were determined. 30 datapoints per patient were collected and submitted to the study via a secure online website.

10745

PATIENTS

375

CENTRES

58

COUNTRIES

View the GlobalSurg 1 results in a snapshot

Global Surgery One Infographic
GSU Case Study Burns
GSU-Studies-Access-1

CEI Case Study - Tiger

Project Tiger Case Study

CEI STARFISH Case Study

More information about our work in rural Ghana will be published soon. Until then, please have a look at the poster we presented at our annual GSU prioritisation workshop in Accra, Ghana, in November 2019.

CEI Case Study - Tiger
Tiger Case Study Poster

Bringing together surgeons, researchers and policy makers to set the local research agenda according to patient need in LMIC and ensuring all patients have the opportunity to take part in our research.


CEI Case Study - Starfish

Project Starfish Case Study

CEI STARFISH Case Study

SToma cARe For Improvement reSearcH (STARFISH): Epidemiologic study of stoma cases in Lower- and Middle-Income Countries and qualitative research on the challenges of stoma care

The reasoning behind the STARFISH study

The STARFISH study was proposed in 2019 by Dr Carmela (Mela) Lapitan, who heads our NIHR GSU Centre in The Philippines.

Mela says even though there has been immense research done into stoma care in high income countries with patients now being well supported and top notch appliances being provided, there is little research into practical problems, as well as feasible and affordable solutions in low resource settings. Her NIHR-funded STARFISH study therefore sets out to assess the burden and experience of stoma surgery and the challenges of stoma care in LIMCs with the aim to capture patients’ biggest challenges, particularly on access to and availability of stoma appliances, and to generate information and develop methods to encourage further research.

Stoma Care

Patients Doing Research vs. Patients Being Researched

As outlined in the ‘Background’ video, the study is heavily patient-centered with a major aspect of it being focus groups and one-to-one interviews with stoma patients, informal caregivers, health care providers and staff involved in stoma care services to gather information on experiences, priorities, challenges and coping strategies relating to stoma care. Mela therefore felt it was crucial to involve patients in the design of the study to help highlight barriers to participation and inform the smooth running of focus groups and interviews. Patients being part of the research team: A new concept in The Philippines that turned out to have its challenges and obstacles.

In the next video, Mela outlines the why, how and what of patient involvement with STARFISH.

Mela experienced the ‘challenge of engaging a patient as part of the research team because of very poor awareness on research and their potential contribution to such beyond being a participant.’ – Something that the Global Surgery Unit encounters in other LMICs, as well. Is this highlighting the need for more health education?

Take Home Messages

Mela’s Top Tipps

If possible, learn from other’s experience and utilise their expertise,
E.g. for STARFISH: Early engagement of a social scientist with links into communities in the conceptualisation and design of the study

Make sure that involved patients or community members represent people relevant to your study, preferably with lived experience

If possible, engage with patient groups. This will not only help inform and shape the study, but also help with recruitment of participants later on

Bringing together surgeons, researchers and policy makers to set the local research agenda according to patient need in LMIC and ensuring all patients have the opportunity to take part in our research.