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Mapping the Advancement of Safe Surgery

Jeff Blossom, MA

Dr. Atul Gawande, MD, MPH

Priya Desai, MPH

ESRI International Users Conference - July 13, 2010

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“…to advance public health through learning, discovery, and communication…”

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Task: To improve the safety of surgical care around the world.

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Result: An international team of experts was organized to figure out how to improve surgical care worldwide.

World Health Organization

Patient Safety

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London, UK

EURO

EMRO

WPRO I

SEARO

AFRO

PAHO I

Amman, Jordan

Toronto, Canada

New Delhi, India

Manila, Philippines

Ifakara, Tanzania

WPRO II

Auckland, NZ

PAHO II

Seattle, USA

Checklist implementation pilot sites

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Pilot study results

The WHO Surgical Safety Checklist reduced the rate of major complications by 36% and the rate of deaths by 43% in the eight pilot hospitals.

WORLDWIDE

DISSEMINATION

EFFORT

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Worldwide Dissemination led by the

Safe Surgery Saves Lives Team

And a Map!?

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GIS Help Desk

Tuesday, 1:30 – 4:00

“…to support research and education that relies on geographic information…”

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Yes, a map

  • On the web, Google map background
  • Pilot site markers
  • Operations per country

thematic overlay.

  • Participating hospitals

and organization locations

  • Clickable information window

pop-ups for each location

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  1. For use by the Safe Surgery Saves Lives Team
      • Track checklist dissemination
      • Maintain database of checklist registrants
  2. For use by hospitals to get a sense of participating hospitals/checklists in the surrounding area.

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Initial Surgical Safety Web Map

  • Built on the Google Maps API (javascript, html)
  • Hospitals geocoded using Batchgeocode.com
  • Point markers in KML format - imported Batchgeocode.com lat/long values to ArcMap, exported to KML
  • Participating hospitals counter KML screen overlay

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  • Surgical Rates map created in ArcMap, loaded into Global Mapper, exported as a tile cache.

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Initial Surgical Safety Web Map

  • The Safe Surgery Saves Lives team can visualize active checklist users and institutions that have expressed interest in using the checklist.
  • Allows the team to strategize their dissemination efforts and make plans to target areas that have not been introduced to the Surgical Safety Checklist.

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  • Updating the map to reflect the rapid adaptation of the checklist
    • New registrants want to see their hospital on the map
    • Safe Surgery Saves Lives team relies on the map for the latest registration information
    • Limited data display with KML format
  • Display basic hospital info to the public, and ALL hospital information to the SSSL team.

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BENEFITS:

CHALLENGES:

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Enabling user updates to the map

  • Migration from KML to PostGIS and Mapserver WMS
  • Batchgeocode.com training for the SSSL team.

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  • Web form for uploading new hospitals in CSV format.

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Enabling user updates to the map (cont.)

  • Allowing editing of individual hospital information

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Additional enhancements

  • Displaying the hospitals by participation status

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  • Zoom Box
  • Google search bar
  • WHO logo, disclaimer, and map overlay
  • Banner redesign, sidebar addition
  • Dynamic hospital list display

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More…

  • Highlight WHO Regions

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  • Database query

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  • Map symbology

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  • Cluster display

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More… map symbology

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More…cluster display

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Conclusions

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  • A team of public health research professionals empowered by geographic information.

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    • Incorporates the map into daily workflow
    • Enables better communication, information distribution

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Technologies used:

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Google Maps javascript API Java

Mapserver PostGIS

ArcGIS Server ArcGIS Desktop

Global Mapper Batchgeocode.com

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“The Checklist Manifesto - How to Get Things Right”

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….managing complexity through the use of simple checklists….

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The Checklist to date (7/9/2010):

3,865 registrants representing

120 countries, and

1,640 institutions actively using the checklist.

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Thank you! Questions?

Contact Info:

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Surgical Safety web map: http://maps.cga.harvard.edu/surgical_safety

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Or Google “surgical safety web map”

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Jeff Blossom, MA

jblossom@cga.harvard.edu

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Dr. Atul Gawande, MD, MPH

safesurgery@hsph.harvard.edu

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Priya Desai, MPH

pdesai@hsph.harvard.edu

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Acknowledgements and sources

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Dave Siegel

Giovanni Zambotti

World Health Organization

Brigham and Women’s Hospital

Harvard School of Public Health

Harvard Medical School

“The Checklist Manifesto – How to Get Things Right”

maps.google.com

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