Associate Editors
Cheryl K. Gooden, MD, FAAP
Helen V. Lauro, MD, FAAP

28th Annual promo

Non-governmental Organization Anesthesia Clinical Outcomes Registry

By Richard Gillerman, MD, PhD
Warren Alpert School of Medicine, Brown University
Providence, RI 

and Faye M. Evans, MD
Chair, SPA Committee on International Education and Service
Department of Anesthesiology, Perioperative and Pain Medicine
Boston Children's Hospital
Boston, MA

Calling All SPA NGO Overseas Surgical Trip Volunteers!

Many SPA members are actively involved in anesthesia care delivery in low-resource settings around the globe.  Volunteer activities include providing direct patient care on overseas surgical trips, educating colleagues abroad, or participating in some hybrid model between the two.  Similar to surgical cases in the U.S., those models that involve direct patient care incur the risk of adverse patient outcomes.  To better monitor and evaluate these events, the Anesthesia Quality Institute (AQI) has recently instituted a new Non-governmental Organization (NGO) registry similar to the existing National Anesthesia Clinical Outcomes Registry (NACOR) for U.S. based practices. 

Improving patient safety and the quality of care delivered on overseas NGO trips is a goal to which all NGOs ascribe. However, data that might help guide important decisions as they relate to quality and safety may be hard to come by.  NGOs may have less vigorous Quality Improvement programs than U.S. based practices because of size limitations, resource constraints, the volunteer nature of their workforce, and a myriad other reasons.  Benchmarking outcomes to those of similar organizations has been particularly difficult because most NGOs have operated with a silo mentality, understandably reluctant to share outcome data.  Despite these obstacles, it is imperative that attempts be made to monitor and evaluate quality and outcome information on these trips, while still taking into account variability that may exist from one venue or organization to another. Such a project has been taken on by the AQI and endorsed by the SPA Committee on International Education and Service.

The potential benefits of this project are numerous; it will give NGOs who have been providing important surgical and anesthesia care around the world for years a tool by which they can work to improve the safety and quality of care delivered to their patients.  Organizations will be better able to evaluate the effects of their patient care delivery model(s), the equipment and monitoring they use, provider types utilized, their patients’ co-morbidities, and other variables.  Hopefully, this information will help participating NGOs make more informed decisions about how best to allocate resources for the best possible outcomes. 

Here’s how it works:

As with the U.S. based NACOR data, the success of this project will depend on the collection of good data, and lots of it. Just as with NACOR, in exchange for participation, a NGO’s individual case and outcome data will be available only to that NGO, to be benchmarked against aggregate NGO outcome data.  Only through the participation of multiple NGOs from small to large, can we hope to identify trends in overseas surgical trip outcomes that will help to lead an NGO, or the international anesthesia community as a whole, towards safer and higher quality delivery of anesthesia care in this environment. 

This is just the beginning.  Once underway, this project can be developed in many directions:

During the development of this program a few questions have come up. 

So, if you volunteer for a NGO that may meet the requirements above, please talk to your organization’s leadership NOW about participating in this exciting project.  You can get more information by emailing directly, or either of the authors,, or

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