Global Perspectives on Task Shifting and Task Sharing in Neurosurgery

Robertson, Faith C.; Esene, Ignatius; Kolias, Angelos G.; Gormley, William B.; Park, Kee B.; Broekman, Marike L D; Rosenfeld, Jeffrey V.; Ammar, Ahmed; Tisel, Magnus; Fuller, Anthony T.; Smith, Timothy R.; Mendez, Ivar; Brennum, Jannick; Matsumara, Akira; Muneza, Sévérien; Rubiano, Andrés M.; Kamalo, Patrick; Fieggen, Graham; Misra, Basant K.; Bolles, Gene; Adelson, David L.; Dempsey, Robert J.; Hutchinson, Peter J.; Nikova, Alexandrina; Ghazala, Osama; Buno, Elubabor; Bhattacharjee, Shibashish; Iizuka, Takahiro; Abdullah, Jafri Malin; Chaurasia, Bipin; Morgan, Eghosa; Alcedo-Guardia, Rodolfo E.; Lucena, Lynne Lourdes N.; Oktay, Kadir; Abdallah, Omar Ibrahim; Saihi, Ahlem; Abdeldjalil, Gacem; Asmaa, Mahi; Yampolsky, Claudio; Saladino, Laura P.; Mannará, Francisco A.; Sachdev, Sonal; Price, Benjamin; Vincent, Joris; Bankole, Nourou Dine Adeniran; Carrasco, Edgar M.; Hodzic, Mirsad; Porto, Marcos Wagner de Sousa; Amorim, Robson Luís Oliveira de; Maldonado, Igor Lima; Yves, Bizoza; Suárez, Gonzalo; Constanzo, Felipe; Atencio, Johanna Cecilia Valdeblanquez; Mora, Karen Alexa Ruiz; Gil, Juan Manuel Rodriguez; Paraskeva, Kiriakos; Egemen, Emrah; Ngamasata, Trevcsor; Ntalaja, Jeff; Beltchika, Antoine; Ntsambi, Glennie; Dunia, Goertz Mirenge; Taha, Mahmoud M.; Arnaout, Mohamed M.; Kirollos, Ramez; Kassem, Mohamed; Elwardany, Omar; Negida, Ahmed; Dolango, Birhanu; Aseged, Mikael; Mldie, Alemu Adise; Laeke, Tsegazeab; Aklilu, Abenezer Tirsit; Adefris, Esayas; Luoto, Teemu M.; Behnam, Rezai Jahromi; Schlichting, Emmanuel De; Bougaci, Nassim; Bourdillon, Pierre; Stienen, Martin N.; Lackermair, Stephan; Schmidt, Franziska Anna; Konczalla, Juergen; Holzgreve, Adrien; Sagerer, André Norbert Josef; Weinert, D.; Kumi, Paulette; McLean, Aaron Lawson; Loan, James J M; Cahill, Julian; Dockrell, Simon; Afshari, Fardad T.; May, Paul; Honeybul, Stephen; Athanasiou, Alkinoos; Papadopoulos, Steven; Espinoza, Edroulfo-Georgios; Chatzisotiriou, Athanasios; Vlachogiannis, Pavlos; Karabatsou, Konstantina; Paschalis, Thanasis; Tsitsipanis, Christos; Calderan, Gabriel Mauricio Longo; Leiva, Ronny; Deora, Harsh; Mukkamala, Sreenivas; Batra, Dipesh; Sukumaran, Arvind; Parmar, Kanishk; Bahl, Anuj; Agrawal, Amit; Dev, Nirankar; Thakur, Nikhil; Behari, Sanjay; Yandrapati, Chandrasekhar B.V.K.; Bhoot, Ritesh; Bhatt, Pragnesh; Bhaumik, Uday; Agrawal, Manish; Thomas, Antony; Chandrappa, Harish; Mathur, Ankit; Wahjoepramono, Petra Octavian Perdana; Oswari, Selfy; Al-Mahfoudh, Rafid; Alnaji, Abbas; Abuhadrous, Nidal; Jarad, Bakr Abo; Nour, Ibrahim; Cohen-Inbar, Or; Colasanti, Roberto; Conti, Alfredo; Raffa, Giovanni; Castrioto, Corrado; Baccanelli, Matteo M.; Tomasi, Santino Ottavio; Zoli, Matteo; Veroni, Andrea; Cristofori, Andrea Di; Giannachi, Luigi; Lippa, Laura; Sgubin, Donatella; Broggi, Morgan; Barbato, Marcello; Restelli, Francesco; Ganau, Mario; Taddei, Graziano; Albadawi, Hamzeh; Salameh, Mohammed; Gulmira, Madieyva; Lashhab, Muffaq; Gaddafi, Walid El; Altoumi, Mohammad; Manvinder, S.M.; Kanesen, Davendran; Teo, Mario; Sriram, Prabu Rau; Zamri, Sarah Atiqah M.; Vinodh, Vayara Perumall; Denou, Moussa; Melhaoui, Adyl; Outani, Oumaima; Boutarbouch, Mahjouba; Gretschel, Armin; Yadav, Pradhumna; Karmacharya, Balgopal; Incekara, Fatih; Boogert, Hugo den; Lopez, Buccket Argvoello; Amadou, Hassane Ali; Sale, Danjuma; Bello, Sanusi; Edward, Poluyi; Ukachukwu, Alvan; Nwaribe, Evaristus; Aniaku, Ikechukwu; Ndajiwo, Aliyu Baba; Ayodele, Olabamidele; Bot, Gyang Markus; Achebe, Sunday David Ndubuisu; Jamal, Bakht; Tariq, Muhammad; Farooq, Ghulam; Khan, Tariq; Khan, Danyal Z.; Khizar, Ahtesham; Hussain, Zahid; Nazir, Anisa; Gonzáles-Portillo, Marco; Bautista, Jhosep Silvestre; Torres, Roland; Javier-Lizan, Abigail; Santos, Isagani Jodl G. de los; Morais, Nuno; Dias, Lydia; Noronha, Carolina; Silva, Jovelo Monteiro; Seromenho-Santos, Alexandra; Lozanche, Kiril; Negoi, Ionuț; Taşcu, A.; Kozyrev, Danil A.; Nkeshimana, Menelas; Karekezi, Claire; Ndayishyigikiye, Marcel Didier; Alabbass, Faisal; Farrash, Faisal; Alhazmi, Rawan; Golubović, Jagoš; Lepifá, Milan; Iliƒá, Rosanda; Stanimirovifá, Aleksandar; García-García, Sergio; Arias, Carlos A. Rodriguez; Lau, Ruth; Delgado-Fernández, Juan; Arráez, Miguel Ángel Escribano; Mateos, C. Fernandez; Leon, Ana M. Castano; Wadanamby, Saman; Bervini, David; Shabani, Hamisi K.; Limpastan, Kriengsak; Ayadi, Khalil; Sencer, Altay; Yalçınkaya, Ali; Eren, Elif; Balak, Naci; Basaran, Recep; Gökoğlu, Abdülkerim; Mykola, Vyval; Tayong, Felicita; Rosseau, Gail; Zuccarello, Mario; Quinsey, Carolyn; Dewan, Michael C.; Young, Paul H.; Laws, Edward R.; Rock, Jack; Kurland, David B.; Muh, Carrie R.; Aguilar, Eri Dario Delgado; Burns, Kenneth R.; Low, Jacob; Keogh, Conor; Uff, Chris; Spina, Alfio; Alelyani, Fayez

doi:10.1016/j.wnsx.2019.100060

Cited by 32 publications

(15 citation statements)

References 22 publications

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“…Optimization of care by reorganization was employed in some Italian and Spanish centers, where the responsibility of neurosurgical emergencies was concentrated to some centers while others took responsibility for regional elective care and still others shifted tasks to manage Covid-19 patients. Such task shifting [23] and concentration by sub-specialization are possible in healthcare systems that have several smaller centers, but not in countries like UK, Ireland, Denmark, Sweden, and Finland that already have fewer large regional centers with catchment areas often over 2,000,000 inhabitants. Moreover, the number of neurosurgical beds/1,000,000 was already low in the latter groups of countries, providing for only a small number of potential beds; these beds may have been used as efficiently as already under normal conditions.…”

Section: Survey Of Practice During Pandemic As Reflected By Changesmentioning

confidence: 99%

A snapshot of European neurosurgery December 2019 vs. March 2020: just before and during the Covid-19 pandemic

et al. 2020

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Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or Covid-19), which began as an epidemic in China and spread globally as a pandemic, has necessitated resource management to meet emergency needs of Covid-19 patients and other emergent cases. We have conducted a survey to analyze caseload and measures to adapt indications for a perception of crisis. Methods We constructed a questionnaire to survey a snapshot of neurosurgical activity, resources, and indications during 1 week with usual activity in December 2019 and 1 week during SARS-CoV-2 pandemic in March 2020. The questionnaire was sent to 34 neurosurgical departments in Europe; 25 departments returned responses within 5 days. Results We found unexpectedly large differences in resources and indications already before the pandemic. Differences were also large in how much practice and resources changed during the pandemic. Neurosurgical beds and neuro-intensive care beds were significantly decreased from December 2019 to March 2020. The utilization of resources decreased via less demand for care of brain injuries and subarachnoid hemorrhage, postponing surgery and changed surgical indications as a method of rationing resources. Twenty departments (80%) reduced activity extensively, and the same proportion stated that they were no longer able to provide care according to legitimate medical needs. Conclusion Neurosurgical centers responded swiftly and effectively to a sudden decrease of neurosurgical capacity due to relocation of resources to pandemic care. The pandemic led to rationing of neurosurgical care in 80% of responding centers. We saw a relation between resources before the pandemic and ability to uphold neurosurgical services. The observation of extensive differences of available beds provided an opportunity to show how resources that had been restricted already under normal conditions translated to rationing of care that may not be acceptable to the public of seemingly affluent European countries.

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Section: Survey Of Practice During Pandemic As Reflected By Changesmentioning

confidence: 99%

A snapshot of European neurosurgery December 2019 vs. March 2020: just before and during the Covid-19 pandemic

et al. 2020

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“…However, the developing and under-developed countries are facing a bigger shortage of neurosurgeons with ratios of 1 neurosurgeon per 10 million population [15]. It is estimated that nearly 23,000 more neurosurgeons are required to be trained globally to treat at least five million essential neurosurgical cases each year [16]. Philippines, which is divided into 12 regions geographically, with just above 100 million population, is served by about 120 neurosurgeons, with ratio of near to one neurosurgeon to 0.8 to 1 million population.…”

Section: The Population-based Requirement Of Neurosurgeonsmentioning

confidence: 99%

Review of global neurosurgery education: Horizon of Neurosurgery in the Developing Countries

et al. 2020

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Globally, the discipline of neurosurgery has evolved remarkably fast. Despite being one of the latest medical specialties, which appeared only around hundred years ago, it has witnessed innovations in the aspects of diagnostics methods, macro and micro surgical techniques, and treatment modalities. Unfortunately, this development is not evenly distributed between developed and developing countries. The same is the case with neurosurgical education and training, which developed from only traditional apprentice programs in the past to more structured, competencebased programs with various teaching methods being utilized, in recent times. A similar gap can be observed between developed and developing counties when it comes to neurosurgical education. Fortunately, most of the scholars working in this field do understand the coherent relationship between neurosurgical education and neurosurgical practice. In context to this understanding, a symposium was organized during the World Federation of Neurological Surgeons (WFNS) Special World Congress Beijing 2019. This symposium was the brain child of Prof. Yoko Kato-one of the eminent leaders in neurosurgery and an inspiration for female neurosurgeons. Invited speakers from different continents presented the stages of development of neurosurgical education in their respective countries. This paper summarizes the outcome of these presentations, with particular emphasis on and the challenges faced by developing countries in terms of neurosurgical education and strategies to cope with these challenges.

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“…In low- and middle-income countries, this would allow for wider availability without the constraint related to the routine use of general anesthesia in both adult ( 11 ) and pediatric population ( 12 ). Other initiatives, such as task sharing in neurosurgery (that is, delegating certain neurosurgical tasks to non-neurosurgical specialists) and partnerships between developing countries for international training programs, could be useful to increase neurosurgical capacities in regions where workforce deficit remains substantial ( 13 , 14 ).…”

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confidence: 99%