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...
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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
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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
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HHS/HRSA
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Funding Flow
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Funding Flow
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Funding Flow
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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.
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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
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Clinical Assessment for Systems Strengthening (ClASS)
Harvard/BHP-PEPFAR AssessmentJanuary 25-February 5, 2010
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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.
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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
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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
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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
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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.
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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
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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.
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Proposed Schedule
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Staff Interviews
Executive Director Clinic Director Site Manager Core Master Trainers Physicians Nurses Pharmacy Staff Laboratory Staff Other relevant staff
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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
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Questions & Answers