Transcript Transition Assessment

Clinical Assessment for Systems
Strengthening (ClASS)
HARVARD-BHP ASSESSMENT
Entrance Meeting
JOSE “RAFI” MORALES, MD, FACOG
CHIEF MEDICAL OFFICER
January 26, 2010
HRSA, HIV/AIDS BUREAU, GLOBAL HIV/AIDS PROGRAM
Entrance Meeting
AGENDA
1.
2.
3.
4.
5.
6.
Introductions
Who is HRSA?
HRSA’s Role in PEPFAR
Assessment Overview
Today’s schedule
Questions and Answers
HHS/HRSA
PEPFAR
(Office of the Global AIDS Coordinator)
Department
of State
US Agency for
International
Development
(USAID)
Health Resources
and Services
Administration
(HRSA)
US
Department
of Health
and Human
Services
Center for
Disease Control
and Prevention
(CDC)
US Peace
Corps
National
Institute of
Health
(NIH)
Department
of Defense
Others
Department
of Labor
Others
Funding Flow
PEPFAR
(Office of the Global AIDS Coordinator)
US Department of Health and
Human Services
Health Resources and
Services Administration
(HRSA)
Catholic
Relief
Services
Harvard
University
Center for Disease
Control and Prevention
(CDC)
Elizabeth
Glaser Ped
AIDS Ftn.
Columbia
University
Funding Flow
US Department of Health and
Human Services
Health Resources and
Services Administration
(HRSA)
Catholic
Relief
Services
Harvard
University
BHPPEPFAR
APIN
Center for Disease
Control and Prevention
(CDC)
MDH
Funding Flow
US Department of Health and
Human Services
Center for Disease Control
and Prevention
(CDC)/Botswana
BHPPEPFAR
HRSA Global HIV/AIDS Portfolio
Care and Treatment
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
No. of Countries
Est. FY09 Funding
Level
Capacity Building/Training
Grantee:
Function
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
* Grantee newly awarded in April, 2009. The grantees projects to work in 6 countries.
HRSA Global HIV/AIDS Program
TRACK 1.0 Care and Treatment
Catholic Relief Services

Works in 10 countries
(187 sites)
Transition to Local Partners:
Completed (FY2009):
 South Africa
Anticipated (FY2010):
 Rwanda
 Zambia
Harvard University

Works in 3 countries
(68 sites)
Transition to Local Partners:
Completed (FY2009):
 None
Anticipated (FY2010):
 Botswana
 Nigeria
Clinical Assessment for Systems Strengthening (ClASS)
Harvard/BHP-PEPFAR Assessment
January 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.
Assessment Team
WEEK 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 Schedule: Week One
Date(s)
Mon.
1/25/10
Tues.
1/26/10
Wed.
1/27/10
Thurs.
1/28/10
Fri.
1/29/10
Site/Organization Name
Meeting with CDC/Botswana
Meeting Harvard/BHP, MOH & Ministry of Local Government
(MLG)
Deborah Retief Memorial Hospital and Lab, Morwa Clinic
Drive to Tsabong
Werda Clinic
IDCC & Laboratory
Time
8 AM
PM
All day
All day
All day
Middlepits Clinic
AM
Bokspit Clinic and Strysendum Health Post
PM
Assessment Schedule: Week Two
Date(s)
Mon.
2/1/10
Tues.
2/2/10
Wed.
2/3/10
Site/Organization Name
Meeting with CDC/Botswana
Princess Marina IDCC & Pharmacy
Meeting with BHP & MoH, and MLG
BHP
Botswana-Harvard HIV Reference Lab
BHP
M&E Unit
BHP
Thurs.
2/4/10
Fri.
2/5/10
Time
AM
AM
PM
All day
PM
All day
PM
All day
Tlokweng Clinic and Site Managers Meeting
AM
Failure Management Workshop/Training
PM
Debrief meeting with CDC/Botswana
AM
Debrief meeting with Harvard/BHP, MOH and MLG
PM
Site Assessment Components

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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
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
Support from:
To
Through

Core Clinical
Master Trainers:
Six physicians,
two pharmacists,
and four nursemidwives
Site-level
Master
Trainers
Site-level Master
Trainers
HCPs



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


Initial and on-going trainings
Direct supervision and support


Assessment Components: Training
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.
Support from:
Core Lab Master
Trainers
To
Site Lab
Master
Trainers
HCPs







Through
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
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
Proposed Schedule

8:00-9:00
Entrance Meeting
 Welcome & Introductions
 Site presentation
 HRSA presentation
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



9:00-9:30
9:30-10:30
10:30-12:00
12:00-12:15
12:15-1:00
Facility Tour
Interviews with Clinic staff
Interviews with Lab staff
Team discussion
Exit meeting
Staff Interviews



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
Executive Director
Clinic Director
Site Manager
Core Master Trainers
Physicians
Nurses
Pharmacy Staff
Laboratory Staff
Other relevant staff
On-Site Review

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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