ID #159 Centralizing neurosurgery as a strategy to improve outcomes in children with brain tumors at an institution in a middle-income country.
Alma Edith Benito Resendiz, Ramiro López, Ricardo Valdez, Blanca Almazan, Jeannie García, Patricia Pérez, Sheila Vega, Mauricio Rodriguez, Alejandra Lopez, Michelle Villavicencio, Georgina Ochoa, Eduardo Baños, San Juanita Sandoval, Farina ArreguínAbstract
The ISSSTE (Institute of Social Security and Services for State Workers) has an structure divided into three levels of care to offer services ranging from basic to highly specialized to meet the needs of its population.
Although the ISSSTE has a functional referral system from primary to secondary or tertiary levels of medical care, in pediatric neuro-oncology we frequently faced a problem: pediatric patients with brain tumors initially arrived at primary or secondary care hospitals and were commonly operated under suboptimal conditions for an oncological pathology, delayed the start of their cancer treatment, which invariably should be received at the tertiary level of medical care.
In order to reduce these complications and provide greater opportunities for therapeutic success for patients, we designed a certification strategy for hospitals qualified to perform pediatric neuro-oncological surgery.
The resources and capabilities of 23 hospitals in total were reviewed, of which 6 potentially could be certificated.
Multiple preliminary meetings were held to define the management process, the design of the evaluation form, and the guide for implementing the certification. This allowed the evaluation committee to conduct thorough assessments, with sufficient information regarding material and human resources, to determine the certification of these hospitals, ensuring they have the necessary tools for best practices.
In total, seventeen evaluators of diferent specialties conducted evaluation visits to flagship ISSSTE units.
Among the areas and points to be verified were: human resources, material resources, care processes, and multidisciplinary collaboration. This process detailed the areas for improvement and the main strengths that enable four of the six evaluated hospitals to have the capacity to resolve cases. These four hospitals have been certified to further strengthen the strategies implemented by ISSSTE aimed at improving the survival and quality of life of children and adolescents with brain tumors.