Inguinal hernia is one of the most common ailments known to mankind. When symptomatic it can severely affect the patient’s quality of life. Nevertheless, the vast majority of inguinal herniorrhaphies are elective and, therefore, not available to uninsured patients who do not have the financial wherewithal to pay for the operation. Using the Surgery on Sunday model developed in Kentucky, Hernia Repair for the Underserved (HRFU) developed a free clinic for hernia surgery at Creighton University Medical Center (CUMC) two years ago, based on institutional commitment to the poor as well as the volunteer efforts of medical students and hospital personnel at CUMC and Bergan Mercy Hospital in Omaha.
Hernia Repair for the Underserved consulted with a local free clinic physician, Dr. Hans Dethlefs at the One World clinic in Omaha and the Federal Tort Claims Act (FTCA) medical legal protection application was submitted and accepted. Under this law, all hospital credentialed volunteer professionals are medico-legally protected if the surgery is performed in an associated free clinic. Committee meetings to work out logistics of the pre-op clinic, the follow-up clinic, enlistment of other volunteers such as transporters, translators, housekeeping for the ORs, a pharmacist, registration personnel were completed. A memorandum of understanding with the hospital system was co-signed. The organizing committee was chaired by Matt Kayl RN and director of the CUMC and Bergan Mercy operating rooms.
Fifteen patients were seen in the pre-operative clinic by Dr. Dethlefs. Patients were operated upon using 3 operating rooms and a volunteer staff of 4 surgeons, 4 anesthesia personnel, 15 nurses, 3 surgical technicians, two translators, one instrument cleaner, a logistics coordinator, a housecleaner, a pharmacist and 7 medical students. Three umbilical hernias were repaired, and 13 inguinal hernias were repaired including two chronically incarcerated hernias.
The average OR turn over time was 31 minutes and there were no intraoperative or early postoperative complications. All patients were discharged home by 6:00 PM. Below are pictures of personnel and OR teams.
Margie from Housecleaning Renee our instrument cleaner
PACU team with Pharmacist
Our translators Isis and Samantha Four of the medical students
The room 7 team
The room 8 team
The room 9 team
The Pre-Op Post-Op Team
Janese Gerhardt with a well-deserved thanks from one of the patient families
Hospital administration is complicated in modern times but finding the time and finances to assist the poor has always been a priority at Creighton University. Mr. Kevin Nokels, the CUMC hospital CEO, Matt Kayl and Pat Townley are thanked for their support and work. Janese Gerhardt RN contributed over 40 hours of time to prepare the patients and paper work plus work during all clinics and the operative day – Janese thank you! Sharon Cyr RN contributed over 20 hours and was essential to the success of this initiative. Dr. Hans Dethlefs worked all the patients up and coordinated care beautifully. Thank you to Dr. James Manion and Theresa Keefe CRNA from the anesthesia department who have been intimately involved in over 20 humanitarian surgical activities and provide compassionate very high quality care that makes continued programs possible, and to Dr. Robert Fitzgibbons who has headed the surgical team and provided hernia surgical expertise that is almost impossible to match. Finally to the many other devoted volunteers who have repeatedly assisted the poor and to the new volunteers who in fact made this initiative possible.