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Published on: January 15, 2017
Task Sharing in Global Cardiac Surgery: A Scoping Review
Laura DiChiacchio1, Alejandra Castro-Varela2, Dominique Vervoort3,4
1Division of Cardiothoracic Surgery, Department of Surgery, University of Utah, Salt Lake City, Utah.
Insights
Task sharing in cardiac surgery is limited in low-resource settings, with few studies exploring its application and outcomes. This review summarizes existing literature on task sharing for cardiac surgical care.
Area of Science:
- Global Health
- Surgical Care Delivery
- Health Workforce Development
Background:
- Access to cardiac surgical services is severely limited in low- and middle-income countries due to a shortage of specialized providers.
- Task shifting and task sharing enable non-specialists to perform tasks traditionally done by cardiac surgeons and anesthesiologists.
- Task sharing has demonstrated success in improving access and maintaining outcomes in other surgical specialties.
Purpose of the Study:
- To conduct a scoping review of the existing literature on task sharing in cardiac surgical care.
- To identify and summarize the applications and outcomes of task sharing in cardiac surgery, particularly in resource-variable contexts.
Main Methods:
- A comprehensive scoping review was performed following PRISMA-S guidelines.
- Searches were conducted across major databases including PubMed/MEDLINE, Embase, WHO Global Index Medicus, and Web of Science.
- The search strategy focused on identifying articles specifically addressing task sharing within cardiac surgical care.
Main Results:
- Only four relevant articles were identified in the review.
- One article detailed task sharing between senior and junior cardiac surgeons in a single-center case study.
- Two studies examined task sharing within a team-based approach for rheumatic heart disease, and one discussed cost-effectiveness including task sharing.
Conclusions:
- There is a significant lack of published literature on the implementation and outcomes of task sharing in cardiac surgery, especially in resource-limited settings.
- The current evidence base is insufficient to fully understand the potential and challenges of task sharing in this field.
- Further research is needed to explore the applications and effectiveness of task sharing for improving cardiac surgical care globally.
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.
