Touching Hands is an international and domestic surgical outreach program that receives support from the American Society for Surgery of the Hand. Like Operation Smile and many other medical missions, volunteers donate their time to provide life-changing treatment to people in need.
When Donald H. Lee, M.D., an orthopaedic surgeon and director of the Hand and Upper Extremity Fellowship Program at Vanderbilt University Medical Center, became active in the program, he started looking for a way to evaluate the work being performed by surgeons, nurses, anesthesiologists, technicians and other professionals in the United States and abroad. Today he serves as chair of the American Society for Surgery of the Hand’s Domestic Outreach Committee.
“We saw the need to develop a standardized, consistent and comprehensive approach to collecting and evaluating data from Touching Hands missions,” Lee said.
Working with medical resident and mentee Kaitlyn Reasoner, M.D., and other colleagues, Lee developed a data-collecting and analyzing platform that can give Touching Hands managers and funders an efficacy snapshot based on a variety of sources, including patient outcomes, volunteer impact, disease burden reduction and overall cost-effectiveness.
Dive into Data
As Touching Hands’ first systematic data collection and analysis initiative, it provided welcome insight into the efficacy of its operations at outreach events across the country, as well as on international missions.
“Now we have a prototype for measuring success here as well as in other humanitarian medical and surgical missions,” Lee said.
Flexibility of the platform is one of its strengths, Reasoner said, with organizers left to decide to participate in none, some, or all of the data-collecting capabilities for a particular mission.
“Since medical mission data can be hard to collect, this is a real benefit, because it allows them to measure some aspects of their mission, at least.”
Abroad and At Home
While Touching Hands launched with a focus on international missions in 2013, the charity conducted its first daylong domestic outreach session at a medical center in Atlanta for people who fell between the insurance cracks in their region.
“Now we have a prototype for measuring success here, as well as in other humanitarian medical and surgical missions.”
In 2017, Vanderbilt welcomed its first Touching Hands Day. Since then, the Nashville-based medical center has sponsored an annual Touching Hands Day, now averaging about 12 to 15 hand surgeries per event. Several other cities in the U.S. now have similar outreach days, Lee said.
“These programs are focused on hand surgery, but we have expanded our program to include orthopaedic sports patients, and we foresee other subspecialties becoming involved over time.”
Trial Run Outcomes
As they began devising the assessment platform, Lee and his collaborators created a template for use on four domestic and three international missions in 2020 and 2021. They employed Vanderbilt’s software platform REDCap (Research Electronic Data Capture) for gathering data, and used validated questionnaires to collect patient-reported outcomes and satisfaction measures.
Patient satisfaction, defined as patients’ reflection that they would choose the same treatment again, was 95 percent, Lee said.
Volunteers were assessed on their level of professional burnout with queries on emotional exhaustion, depersonalization and personal accomplishment. While these data showed a slight but not statistically significant reduction in burnout following program involvement, the impact may be more dramatic when longer, international missions resume, Lee and Reasoner agreed.
“We know that there is, in general, a decrease in burnout after mission trips,” Lee said. “Volunteers themselves seem to get this feeling of gratitude that through their generosity, they’re able to help other people.”
The researchers also calculated a reduction in disability-adjusted life years (DALYs) based on several factors, including life expectancy and condition severity. The pilot missions restored a combined DALY value of 140 years of healthy life to patients.
Outreach Days in Nashville
Lee and Reasoner will apply their model to capture measures of effectiveness for upcoming Vanderbilt events and beyond, ramping up as COVID-19 dies down.
Vanderbilt’s next Touching Hands Outreach Day, its sixth, will take place on August 20, 2022. Vanderbilt supplies the surgical facilities and equipment and participating Vanderbilt medical staff give up their Saturday to come together for this life-altering event.
“The logistics are a fair amount of work, but it’s truly a gratifying and worthwhile endeavor for all,” Lee said. “Now, we have data to support that intuitive knowledge and develop new sites.”