Background. Humanitarian surgical organizations consider both quantity of patients receiving care and quality of the care provided as a measure of success. However, organizational efficacy is often judged by the percent of resources spent towards direct intervention/surgery, which may discourage investment in an outcomes monitoring system. Operation Smile's established Global Standards of Care mandate minimum patient followup and quality of care. Purpose. To determine whether investment of resources in an outcomes monitoring system is necessary and effectively measures success. Methods. This paper analyzes the quantity and completeness of data collected over the past four years and compares it against changes in personnel and resources assigned to the program. Operation Smile began investing in multiple resources to obtain the missing data necessary to potentially implement a global Surgical Outcomes Auditing System. Existing personnel resources were restructured to focus on postoperative program implementation, data acquisition and compilation, and training materials used to educate local foundation and international employees. Results. An increase in the number of postoperative forms and amount of data being submitted to headquarters occurred. Conclusions. Humanitarian surgical organizations would benefit from investment in a surgical outcomes monitoring system in order to demonstrate success and to ameliorate quality of care. 1. Introduction A strong argument can be made that the success of humanitarian surgical organizations must consider both quantity of patients receiving care and the quality of the care provided. However, the efficacy of a nonprofit organization is often judged by asking what percentage of an organization’s resources is spent towards direct intervention; in this case, the percentage that goes directly towards providing surgery. Such scrutiny might discourage humanitarian organizations from investing in adequate review of their outcomes, to the detriment of the patients being served. In order for surgical outcomes to be effectively monitored for both patient followup and measuring success, adequate resources need to be allotted towards the establishment of effective systems. Operation Smile, an international medical nonprofit providing free surgical care for children with clefts, is striving towards measuring its success both by the quantity and quality of care it provides. In 2006, Operation Smile and representatives from its global medical community established the Global Standards of Care, mandating minimum requirements of
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