Coordination and Pilot Implementation of a Standardized Data Collection for Touching Hands

Published:October 14, 2022DOI:


      Touching Hands is an American Society for Surgery of the Hand program that provides hand surgeries to the world’s underserved communities. The purpose of this study was to develop and implement a systematic data collection method for Touching Hands to assess patient outcomes, volunteer impact, alleviated disease burden, and cost-effectiveness.


      Research electronic data capture (REDCap) was used as the secure software platform to facilitate data collection. The Quick Disabilities of the Arm, Shoulder and Hand questionnaire was used to assess pre-and postoperative patient-reported outcomes. The Maslach Burnout Inventory-Human Services (Medical Personnel) survey was administered to volunteers before and after the mission to measure impact on volunteers. Case information was collected to calculate disability-adjusted life years and cost-effectiveness.


      The data collection system was implemented in some capacity in 4 domestic and 3 international mission sites during 2020 and 2021.


      Substantial limitations exist for the implementation of a systematic data collection framework for Touching Hands and warrant further modification and optimization.

      Clinical Relevance

      A REDCap database can be used for standardized and centralized patient and volunteer data collection for Touching Hands missions.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Hand Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Kozin S.H.
        The richness of caring for the poor: the development and implementation of the touching hands project.
        J Hand Surg Am. 2015; 40: 566-575
        • Zitzman E.
        • Berkley H.
        • Jindal R.M.
        Accountability in global surgery missions.
        BMJ Glob Health. 2018; 3e001025
        • Sykes K.J.
        Short-term medical service trips: a systematic review of the evidence.
        Am J Public Health. 2014; 104: 38-48
        • McQueen K.A.K.
        • Hyder J.A.
        • Taira B.R.
        • Semer N.
        • Burkle F.M.
        • Casey K.M.
        The provision of surgical care by international organizations in developing countries: a preliminary report.
        World J Surg. 2010; 34: 397-402
        • Chuang C.
        • Azurdia J.
        • Asuzu D.
        • et al.
        Functional and quality of life outcomes of a hand surgery mission to Honduras.
        Hand (NY). 2018; 13: 305-312
        • Saluja S.
        • Mukhopadhyay S.
        • Amundson J.R.
        • et al.
        Quality of essential surgical care in low- and middle-income countries: a systematic review of the literature.
        Int J Qual Health Care. 2019; 31: 166-172
      1. Shapiro LM, Đình MP, Fox PM, Richard MJ, Eppler SL, Kamal RN. Barriers and facilitators of outcome collection during hand surgery outreach: a quality improvement study. Hand. Published online ahead of print, April 21, 2021.

      2. Welch JM, Kamal RN, Chatterjee M, Shapiro LM. Rates, barriers, and facilitators of outcome collection on hand surgery outreach to low- and middle-income countries. Hand. Published online ahead of print, January 20, 2022.

        • Quinn J.
        • Barnard Q.
        • McKone-Sweet K.
        • Schlesinger L.
        Surgical Quality Assurance Database (SQUAD) in Uganda.
        Part A and Part B, 2015
        • Shapiro L.M.
        • Chang J.
        • Fox P.M.
        • et al.
        Measuring and improving the quality of care during global outreach trips: a primer for safe and sustainable surgery.
        J Hand Surg Am. 2020; 45: 851-856.e2
        • Shapiro L.M.
        • Đình M.P.
        • Tran L.
        • Fox P.M.
        • Richard M.J.
        • Kamal R.N.
        Short message service-based collection of patient-reported outcome measures on hand surgery global outreach trips: a pilot feasibility study.
        J Hand Surg Am. 2022; 47: 384.e1-384.e5
        • Shapiro L.M.
        • Kamal R.N.
        Implementation of electronic health records during global outreach: a necessary next step in measuring and improving quality of care.
        J Hand Surg Am. 2022; 47: 279-283
        • Bernstein D.N.
        • Agarwal-Harding K.J.
        • Dyer G.S.M.
        • Rozental T.D.
        Outcomes measurement in global hand surgery.
        J Hand Surg Am. 2020; 45: 865-868
        • Reasoner K.
        • Desai M.J.
        • Lee D.H.
        A helping hand: the case for volunteerism.
        J Hand Surg. 2018; 43: 941-944
        • Campbell C.
        • Campbell D.
        • Krier D.
        • Kuehlthau R.
        • Hilmes T.
        • Stromberger M.
        Reduction in burnout may be a benefit for short-term medical mission volunteers.
        Ment Health, Relig Cult. 2009; 12: 627-637
        • Iserson K.V.
        Burnout syndrome: global medicine volunteering as a possible treatment strategy.
        J Emerg Med. 2018; 54: 516-521
        • Qiu X.
        • Nasser J.S.
        • Sue G.R.
        • Chang J.
        • Chung K.C.
        Cost-effectiveness analysis of humanitarian hand surgery trips according to WHO-CHOICE thresholds.
        J Hand Surg Am. 2019; 44: 93-103
      3. Goldfarb JH, Manteiga A, Wall LB. Cost-effectiveness of pediatric hand international medical missions. J Hand Surg Am. Published online ahead of print, December 17, 2021.

        • Tadisina K.K.
        • Chopra K.
        • Tangredi J.
        • Thomson J.G.
        • Singh D.P.
        Helping hands: a cost-effectiveness study of a humanitarian hand surgery mission.
        Plast Surg Int. 2014; 2014: 1-12
        • Harris P.A.
        • Taylor R.
        • Minor B.L.
        • et al.
        REDCap Consortium, The REDCap consortium: building an international community of software partners.
        J Biomed Inform. 2019; 95103208
        • Harris P.
        • Taylor R.
        • Thielke R.
        • Payne J.
        • Gonzalez N.
        • Conde J.G.
        Research electronic data capture (REDCap) – a metadata-driven methodology and workflow process for providing translational research informatics support.
        J Biomed Inform. 2009; 42: 377-381
        • Gummesson C.
        • Ward M.M.
        • Atroshi I.
        The shortened disabilities of the arm, shoulder and hand questionnaire (QuickDASH): validity and reliability based on responses within the full-length DASH.
        BMC Musculoskelet Disord. 2006; 7: 1-7
        • Rosales R.S.
        • Delgado E.B.
        • De La Lastra-Bosch I.D.
        Evaluation of the Spanish version of the DASH and carpal tunnel syndrome health-related quality-of-life instruments: cross-cultural adaptation process and reliability.
        J Hand Surg Am. 2002; 27: 334-343
        • Alotaibi N.M.
        • Aljadi S.H.
        • Alrowayeh H.N.
        Reliability, validity and responsiveness of the Arabic version of the Disability of Arm, Shoulder and Hand (DASH-Arabic).
        Disabil Rehabil. 2016; 38: 2469-2478
        • Sarasqueta C.
        • Gabaldon O.
        • Iza I.
        • Béland F.
        • Paz P.M.
        Cross-cultural adaptation and validation of the NASS outcomes instrument in Spanish patients with low back pain.
        Eur Spine J. 2005; 14: 586-594
        • Daltroy L.H.
        • Cats-Baril W.L.
        • Katz J.N.
        • Fossel A.H.
        • Liang M.H.
        The NASS Lumbar Spine Outcome Assessment Instrument: reliability and validity tests.
        Spine. 1996; 21: 741-749
        • Polinder S.
        • Haagsma J.A.
        • Stein C.
        • Havelaar A.H.
        Systematic review of general burden of disease studies using disability-adjusted life years.
        Popul Health Metr. 2012; 10: 21
        • De Putter C.E.
        • Selles R.W.
        • Haagsma J.A.
        • et al.
        Health-related quality of life after upper extremity injuries and predictors for suboptimal outcome.
        Injury. 2014; 45: 1752-1758
        • Salomon J.A.
        • Haagsma J.A.
        • Davis A.
        • et al.
        Disability weights for the Global Burden of Disease 2013 study.
        Lancet Glob Health. 2015; 3: e712-e723
        • Maslach C.
        • Jackson S.
        MBI-Human Services Survey for Medical Personnel-MBI-HSS (MP).
        Mind Garden, Inc., 2016
        • McCord C.
        • Chowdhury Q.
        A cost effective small hospital in Bangladesh: What it can mean for emergency obstetric care.
        Gynecol Obstet. 2003; 81: 83-92
        • Gosselin R.A.
        • Thind A.
        • Bellardinelli A.
        Cost/DALY averted in a small hospital in Sierra Leone: what is the relative contribution of different services?.
        World J Surg. 2006; 30: 505-511
        • Saxton A.T.
        • Poenaru D.
        • Ozgediz D.
        • et al.
        Economic analysis of children’s surgical care in low- and middle-income countries: a systematic review and analysis.
        PLoS One. 2016; 11
        • Kruk M.E.
        • Gage A.D.
        • Arsenault C.
        • et al.
        High-quality health systems in the Sustainable Development Goals era: time for a revolution.
        Lancet Glob Health. 2018; 6: e1196-e1252
        • Chao T.E.
        • Sharma K.
        • Mandigo M.
        • et al.
        Cost-Effectiveness of Surgery and Its Policy Implications for Global Health: A Systematic Review and Analysis.
        Lancet Glob Health. 2014; 2: e334-e345
        • Belsky D.
        • Poley S.
        • Gault K.
        • Fraher E.
        • Sheldon G.R.T.
        Surgical deserts in the US: places without surgeons.
        ACS HPR Institute. 2009; : 1-4
        • Padmanaban V.
        • Johnston P.F.
        • Gyakobo M.
        • Benneh A.
        • Esinam A.
        • Sifri Z.C.
        Long-term follow-up of humanitarian surgeries: outcomes and patient satisfaction in rural Ghana.
        J Surg Res. 2020; 246: 106-112
        • Daniels K.M.
        • Yu E.Y.
        • Maine R.G.
        • et al.
        Palatal fistula risk after primary palatoplasty: a retrospective comparison of humanitarian operations and tertiary hospitals.
        Lancet. 2015; 385: S37