Self-sustaining cardiac surgery program established in Ghana

Issue: April 2012

Cardiology 2012

In 2012, staff members at Komfo Anokye Teaching Hospital in Ghana will perform their first independent pediatric cardiac surgery, and the hospital will become the only pediatric CV surgical center in West Africa. This achievement is in large part due to training and education from an interdisciplinary medical team at Children’s Hospital Boston.

Before this training, there were no pediatric cardiac surgeons to serve the population of Ghana. The idea for the Children’s Hospital Boston team to establish a self-sustaining cardiac surgery program there came from Francis Fynn-Thompson, MD, a cardiac surgeon originally from Ghana, who dreamt about traveling back to Ghana to treat the people there.

In 2006, team members traveled to the town of Kumasi, Ghana, and conducted a needs assessment to determine the feasibility of establishing a self-sustaining cardiac surgery program. During their visit at the Komfo Anokye Teaching Hospital, they found no infrastructure, equipment and supplies. The staff there had knowledge and skill deficits on CV anatomy and physiology, congenital heart disease and perioperative care of patients with congenital heart disease. The team returned to Kumasi in 2007 and established best practices through one-on-one mentoring, WHO procedure/hand-off checklists, and by modeling professional and communication skills. Electronic communication and information exchange between the Children’s Hospital Boston and Komfo Anokye Teaching Hospital staffs reinforced continued learning after the 2007 mission, Beverly M. Small, RN, CCRN, told Cardiology Today.

“Our goal is to help make a self-sustaining hospital in Ghana,” Small said. “We are teaching the staff there how to do pediatric cardiac surgery and take care of the children in Ghana, so they can be self-sustaining and perform other surgeries on their own in the future.”

To date, the Children’s Hospital Boston team has made six missions to Ghana, where they evaluated more than 600 children. Seventy-eight children underwent surgical cardiac intervention so far, with “great” outcomes. However, two children have died; one death was related to malaria. The results of the team’s efforts were presented at the 16th Annual Update on Pediatric and Congenital Cardiovascular Disease.

“We encourage the children that we’ve operated on to come back to the hospital for follow-up and echocardiograms to see how they are progressing,” Christine Placidi, RN, BSN, of the Children’s Hospital Boston, said in an interview.

The staff at Komfo Anokye Teaching Hospital is also thriving, Small said. The multidisciplinary staff members have learned assessment skills and can verbalize their understanding of cardiac defects and physiology, vital signs and pain management, and the importance of direct communication within the team. The training they received will not only be utilized during pediatric cardiac surgery, but also in the ICU and during the care of daily patients of all ages.

Although this trip is unique to the team at Children’s Hospital Boston, a group from Seattle has been traveling to Kumasi and training the same personnel to work on adult cardiac surgery patients.

The Children’s Hospital Boston team has planned another mission to Ghana in the fall.

“The ultimate goal this year is to leave enough disposable supplies and equipment for the surgeon to operate on 10 children while we aren’t there,” Small said.

To learn more about the efforts by Children’s Hospital Boston, visit its blog, childrensinghana.typepad.com. – by Casey Murphy

For more information:

Small BM. Abstract #536. Presented at: The 16th Annual Update on Pediatric and Congenital Cardiovascular Disease; Feb. 22-26, 2012; Orlando, Fla.

Disclosure: Ms. Small and Placidi report no relevant financial disclosures.

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