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An evidence-based program for rural surgical and obstetrical networks.
Stuart Iglesias1, Jude Kornelsen2
1Rural Coordination Centre of BC, 620-1665 West Broadway Vancouver BC, V6J 1X1, Canada siglesias64@gmail.com.
Rural and Remote Health
|December 4, 2018
Summary
Rural surgical programs face attrition. A new framework integrates rural care into regional networks, using five pillars to ensure sustainable, high-quality surgical services close to home.
Area of Science:
- Rural Health
- Surgical Network Development
- Healthcare Policy
Background:
- Significant attrition of small-volume rural surgery programs in Western Canada over 25 years.
- The 'Joint position paper on rural surgery and operative delivery' (JPP) proposes nesting rural programs within larger regional ones.
- Emphasis on delivering surgical care as close to home as possible through integrated rural and regional programs.
Purpose of the Study:
- To present a collaborative program developed in British Columbia to overcome challenges in rural surgical care.
- To establish effective networks for rural surgical care based on five key pillars.
- To address issues of stakeholder relationships, skepticism towards family physicians with enhanced surgical skills (FPESS), and minimum volume thresholds.
Main Methods:
- A collaborative effort by key stakeholders in British Columbia.
- Integration of five synergistic pillars: clinical coaching, continuing quality improvement (CQI), remote presence technology, sustainable local surgical capacity, and evaluation.
- Strategic policy implementation to improve rural surgical care.
Main Results:
- Development of a program designed to build effective networks of rural surgical care.
- Synergistic interplay of five pillars to support small surgical sites.
- First-time integration of these five evidence-derived pillars as deliberate strategic policy.
Conclusions:
- The integrated five-pillar approach offers a novel strategy for improving rural surgical care.
- Addressing stakeholder relationships and training concerns is crucial for network success.
- Sustainable rural surgical programs require a focus on quality, technology, capacity, and evaluation.
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