The Impact of Increasing Surgical Capacity at a Tertiary Hospital in Southern Haiti.

Journal Article (Journal Article)


St. Boniface Hospital (SBH) plays a critical role in providing safe, accessible surgery in rural southern Haiti. We examine the impact of SBH increasing surgical capacity on case volume, patient complexity, and inpatient mortality across three phases.

Materials and methods

A retrospective review and geospatial analysis of all surgical cases performed at SBH between 2015 and 2017 were performed. Inpatient mortality was defined by in-hospital deaths divided by the number of procedures performed.


Between February 2015 and August 2017, over 2000 procedures were performed. The average number of surgeries per week was 3.1 with visiting surgical teams in phase 1 (P1), 10.4 with a single general surgeon in phase 2 (P2), and 20.1 with two surgeons and a resident in phase 3 (P3). There was a six-fold increase in surgical volume between P1 and P3 and a significant increase in case complexity. The distribution of American Society of Anesthesiologists scores of 1, 2, 3, and 4 during P2 was 81.05%, 14.74%, 3.42%, and 0.79%, respectively, whereas in P3, the distribution was 68.91%, 22.55%, 7.70%, and 0.84%. Surgical mortality was 0%, 1.2%, and 1.67% across phases.


Increasing resources and surgical staff at SBH allowed for greater delivery of safe surgical care. This study highlights that investing in surgery has a significant impact in regions of great surgical need.

Full Text

Duke Authors

Cited Authors

  • Patterson, RH; Bowder, AN; Jean-Baptiste, T; Eisenson, DL; Wilson, MK; Dodgion, CM; Ward, LE; Padovany, MMN

Published Date

  • July 2019

Published In

Volume / Issue

  • 239 /

Start / End Page

  • 8 - 13

PubMed ID

  • 30782545

Electronic International Standard Serial Number (EISSN)

  • 1095-8673

International Standard Serial Number (ISSN)

  • 0022-4804

Digital Object Identifier (DOI)

  • 10.1016/j.jss.2019.01.025


  • eng