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HARVARD-BHP ASSESSMENT J OSE “R AFI ” M ORALES, MD, FACOG C HIEF M EDICAL O FFICER Clinical...
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Transcript of HARVARD-BHP ASSESSMENT J OSE “R AFI ” M ORALES, MD, FACOG C HIEF M EDICAL O FFICER Clinical...
HARVARD-BHP ASSESSMENT
JOSE “RAFI” MORALES, MD, FACOGCHIEF MEDICAL OFFICER
Clinical Assessment for Systems Clinical Assessment for Systems Strengthening (ClASS) Strengthening (ClASS)
HRSA, HIV/AIDS BUREAU, GLOBAL HIV/AIDS PROGRAMJanuary 26, 2010
Entrance Meeting
Entrance Meeting
AGENDA
1. Introductions
2. Who is HRSA?
3. HRSA’s Role in PEPFAR
4. Assessment Overview
5. Today’s schedule
6. Questions and Answers
HHS/HRSA
Funding Flow
Funding Flow
Funding Flow
HRSA Global HIV/AIDS Portfolio
Grantee: No. of Countries No. of Sites Cum. No. of Individuals on ART
Est. FY09 Funding Level
Catholic Relief Services 10 187 192,400 $134.9 million
Harvard University 3 68 106,500 $58.8 million
Care and Treatment
Grantee: Function No. of Countries Est. FY09 Funding Level
University of Washington (I-TECH) • training • capacity building
14 $48.5 million
American International Health Alliance (Twinning Center)
• twinning partnerships• Mentoring/volunteering
11 $10.6 million
Columbia University (ICAP Nurse Capacity Initiative)
• nursing capacity building 3* $0.89 million
NY AIDS Institute (International HIVQUAL)
• quality improvement 8 $2.1 million
NPI Grantees (5 grantees) • local partner capacity development
5 $4.9 million
Capacity Building/Training
* Grantee newly awarded in April, 2009. The grantees projects to work in 6 countries.
HRSA Global HIV/AIDS ProgramTRACK 1.0 Care and Treatment
Catholic Relief Services
Works in 10 countries (187 sites)
Transition to Local Partners:Completed (FY2009):
South AfricaAnticipated (FY2010):
Rwanda Zambia
Harvard University
Works in 3 countries (68 sites)
Transition to Local Partners:Completed (FY2009):
NoneAnticipated (FY2010):
Botswana Nigeria
Clinical Assessment for Systems Strengthening (ClASS)
Harvard/BHP-PEPFAR AssessmentJanuary 25-February 5, 2010
Purpose
The purpose of the ClASS Harvard-BHP assessment is to conduct a comprehensive review of BHP’s organizational, programmatic, administrative & financial systems capacity to ensure readiness to become a directly funded USG partner.
The assessment methodology has been developed in collaboration with Harvard, BHP, and CDC/Botswana.
WEEK ONEWEEK ONE
HRSA LEAD Rafi Morales, HRSA
TRAINING REVIEWER
Anjali Sharma
REVIEW SUPPORT Christine Lim, HRSA
PROJECT OFFICER Rodrigo Boccanera, HRSA
ADMINISTRATIVE REVIEWER
N/A
FINANCIAL REVIEWER
N/A
Assessment Team
Date(s) Site/Organization Name Time
Mon. 1/25/10
Meeting with CDC/Botswana 8 AM
Meeting Harvard/BHP, MOH & Ministry of Local Government (MLG)
PM
Tues. 1/26/10 Deborah Retief Memorial Hospital and Lab, Morwa Clinic All day
Wed. 1/27/10
Drive to TsabongAll day
Werda ClinicThurs.
1/28/10 IDCC & Laboratory All day
Fri. 1/29/10
Middlepits Clinic AM
Bokspit Clinic and Strysendum Health Post PM
Assessment Schedule: Week One
Date(s) Site/Organization Name Time
Mon. 2/1/10
Meeting with CDC/Botswana AM
Princess Marina IDCC & Pharmacy AM
Meeting with BHP & MoH, and MLG PM
Tues. 2/2/10
BHP All day
Botswana-Harvard HIV Reference Lab PM
Wed. 2/3/10
BHP All day
M&E Unit PM
Thurs. 2/4/10
BHP All day
Tlokweng Clinic and Site Managers Meeting AM
Failure Management Workshop/Training PM
Fri. 2/5/10
Debrief meeting with CDC/Botswana AM
Debrief meeting with Harvard/BHP, MOH and MLG PM
Assessment Schedule: Week Two
Site Assessment Components
Entrance meeting: The assessments begin with an opportunity for the team to meet with the organization’s leadership, HIV clinical and laboratory Master Trainer Corps, and other key staff.
Facility tour (as appropriate): The team tours the facility to gain the perspective of the impact of clinical and laboratory training on quality of care and support to decentralization.
Information gathering: Team members conduct staff interviews and request follow up documents to clarify or confirm information ‐collected.
Exit Conference: At the end of the site visit, the team meets with the organization’s leadership to share findings of the assessment, including strengths and areas for improvement.
Assessment Components: Training
Support from: To Through
Core Clinical Master Trainers:Six physicians, two pharmacists, and four nurse-midwives
Site-level Master
Trainers
Assessment of site-specific training and support needs
Immediate on-site practical support Identification of site-level Physician and
Nurse Master Trainers On-site follow-up support Support and evaluation visit Telephone site support
Site-level Master Trainers
HCPs Initial and on-going trainings Direct supervision and support
Clinical Master Trainer/ARV Site Support Component (CMT): Goal: Further develop and expand a sustainable training capacity in clinical care and treatment of HIV/AIDS patients that provides on-going training and mentoring to ARV sites
Assessment Components: Training
Support from: To Through
Core Lab Master Trainers
Site Lab Master
Trainers
Assessment of site-specific needs Centralized training and mentoring in CD4,
Viral Load, Chemistry, Hematology, and other lab testing
On-going site support Periodic follow-up support and evaluation
visits Telephone site support
HCPs
Provide on-site training and mentoring in labs Evaluate Site Master Trainers in established
labs and Nurses for Rapid HIV Testing and Dry Blood Spot
Laboratory Master Trainer/ARV Site Support Program (LMT): Goal: Support the establishment of decentralized laboratories with CD4 and viral load testing capability by developing a sustainable training program in these tests at the local level.
Proposed Schedule
Staff Interviews
Executive Director Clinic Director Site Manager Core Master Trainers Physicians Nurses Pharmacy Staff Laboratory Staff Other relevant staff
On-Site Review
List of site Clinical and Laboratory Trainings Telephone logs: CMTs, LMTs Mentoring log Site support log Off-site and on-site training/re-training logs Other relevant documents
Questions & Answers