CHILDREN’S HEARTLINK CENTERS OF EXCELLENCE RECOMMENDATIONS Burke B, Forst R, Li Kappe D, Malu A, Secor A McClelland RS, Dooley E June 2019 Photo: CHL
Methods: Extensive SME Interview s & Literature Review • Interviewed 27 Staff & Subject Matter Experts • Reviewed published and grey literature CHL Volunteers & CHL Staff Subject Matter Experts Partners • Ly Phuong Anh – MEET • Barclay Stewart – • Adriana Dobrzycha • Bruna Cury International Operation Smile • Andreas Tsakistos • David Overman • Pam Kohler – University • Beth McNairn – HVO • Anne Betzner • Jeff Paurus of Washington • Dilys Walker - PRONTO • Bistra Zheleva • Mark Lewin • Robert Gertler – MEET International • Courtney Geolat • Steve Schwartz International • Jeffery Burns – • Jackie Boucher • Sandy Staveski • Sarah Orth – Seattle OpenPediatrics Children’s Hospital • Wade Jones • Kathy Jenkins – IQIC • Bruce Avolio – University • Kristin Hatcher – of Washington Operation Smile • Jodie Miner – Swedish • Steven Hatting – Medical Center University of Washington | 2 Foundation
Scaling CHL’s Impact Building on CHL’s successes to save more children with CHD Operational Strategic Opportunities Opportunities Increase # of • Country selection • Public-private hospital • Volunteer Centers of model management • Partnership Excellence • Formalizing nurse development educator program • Impact metrics • Phasing metrics Increase Advance Access to Research and Thought Publication Quality Leadership Opportunities Care • Research funding and training | 3
Increase # of Centers of Excellence: Operational Opportunities
Recommendation: Expand Within Existing Countries CHL has an opportunity to expand the reach by leveraging existing relationships and know-how within current countries Prioritize scale- Consider China up in Brazil, and India for Malaysia, and longer time Vietnam as short horizon time horizon opportunities opportunities | 5
CHD Patient Population 2030 For catchment areas of 50 partners 1 4.6M Geography CHD Population No. Partners India 1.5M 17 TOTAL CHD PATIENT China 1.2M 12 POPULATION Brazil 430,000 9 Vietnam 327,000 6 Malaysia 124,000 3 3 new LIC 205,000 3 | 6
Identifying Enabling Country Environment Strength of evidence Strong Moderate Weak China India Vietnam Malaysia Brazil Increase in GDP spending on healthcare Evidence for successful private-public partnerships Overall conditions for establishing training programs Evidence of UHC 1 , essential surgery or clinical skill development Presence of philanthropic efforts to support CHD treatment Number of medical doctors per 10,000 population 2 | 7
Recommendation: Optimizing Volunteer Management Bolstering recruitment efforts & enabling global collaboration will help CHL prepare the volunteer model to scale Publicize & Enable Standardize Subsidize Knowledge Training Recruitment Transfer Curriculum | 8
Data System to Support Operations A single, integrated data system can help support CHL’s work in four areas Intranet / Volunteer/ Partner Metrics Tracking & CRM Management Dashboards Community Manage Provide forum for Manage volunteer stakeholder volunteer & partner Collect metrics data and partner pipeline communication contacts Record and prompt Manage trip Streamline Evaluate reports on stakeholder logistics onboarding outcomes communications Share onboarding Present Store assessment Track donations and feedback and trip related performance and grants responses documents dashboards Host standard Track follow-up communication curriculum | 9
Example Data System Solution Case Study: Hope On A String (HOAS) operated community center in rural Haiti to empower children and adults through music and performing arts Result Context Challenge: • CRM helps HOAS manage donor Scattered information made process of outreach and pipeline tracking student enrollment, retention, and • Student registration/attendance is now outcomes impossible easily trackable and HQ staff have access Product Solution: Salesforce.org to real-time, actionable data on program Used by 40K + nonprofits and education satisfaction surveys and student institutions globally with dynamic online outcomes support community of users and developers on the Power of Us Hub Potential Cost Considerations • Licenses • Initial setup and training • System admin | 10
Dashboards for Performance Management Aggregate phasing metric data can provide insight into site progress Benefits OVERVIEW • Help CHL internally evaluate performance of partner sites Determine the most relevant metrics to provide insight into • Serve as tool for knowledge transfer and site progress over time. Overlay transparency among volunteer and partner sites progress chart for all selected by helping them compare progress and engage in sites for easy comparison and conversations about best practices display annual information for patients seen, patients treated, • Enable comparison of progress within a hospital and mortality rate over time, and across hospitals • Act as a communication tool for donors and funding agencies | 11
Example Dashboard w ith One Site Institut Jantung Negara | COE PATIENTS TREATED MORTALITY RATE Site Selection PATIENTS SEEN 2018 2018 2018 + Brazil 40 33 4% + China + India Patien ent V Volu lume Postope perativ ive I Infectio ion R Rates es Infant M t Morta tality R ty Rate tes - Malaysia 70 16% 8% Institut Jantung Negara 15% 60 7% 14% + Vietnam 50 13% 6% 40 12% 5% 11% 30 10% 4% 20 9% 10 8% 3% 2014 2016 2018 2014 2015 2016 2017 2018 2019 2014 2016 2018 Institut Jantung Negara Institut Jantung Negara Institut Jantung Negara | 12 * Randomly generated data to convey idea
Example Dashboard w ith Multiple Sites Hospital de Messejana | Phase 1 Institut Jantung Negara | COE Vietnam National Children’s Hospital | Phase 1 PATIENTS TREATED MORTALITY RATE Site Selection PATIENTS SEEN 2018 2018 2018 95 76 5.7% - Brazil Hospital de Messejana Hospital da Crianca e Maternidade + China Patien ent V Volu lume Postope perativ ive I Infectio ion R Rates es Infant M t Morta tality R ty Rate tes 70 18% 8% + India 60 16% 7% 50 14% 6% - Malaysia 40 12% 5% Institut Jantung Negara 30 10% 4% 20 - Vietnam 10 8% 3% Vietnam National Children’s Hospital 2014 2016 2018 2014 2015 2016 2017 2018 2019 2014 2016 2018 Nhi Dong 1 Institut Jantung Negara Institut Jantung Negara Institut Jantung Negara Kien Giang General Hospital Hospital de Messejana Hospital de Messejana Hospital de Messejana Vietnam National Childeren's Hospital Vietnam National Childeren's Hospital Vietnam National Childeren's Hospital | 13 * Randomly generated data to convey idea
Recommendation: Nurse Educators Are Vital For Success Nurse educators create a sustainable way to improve competency of nursing staff and reduce turnover Provide Formalize Hire a nurse support for nurse educator at hiring nurse educator CHL educators at program headquarters partner sites | 14
Nurse Educators Are Highly Cost Effective A case study of nurse educators cost-effectiveness in the pediatric oncology nursing education programs across 7 Latin American countries Cost comparison results 1, 2 : Average Educational Cost per Pediatric Oncology Nurse by Education Model • Short lecture series: 1-2 week lecture series at $7,000.00 partner site = $4,415 / nurse $6,554.00 $6,000.00 • Expanded lecture series: 12-week lecture series $5,190.00 at partner site = $5,190 / nurse $5,000.00 $4,415.00 • Residential training: 3-month residential training $4,000.00 = $6,554 / nurse $3,000.00 • Nurse educator: direct costs of salary and $2,000.00 benefits of a full-time nurse educator providing education to 49 nurses 01/07-09/09 $1,000.00 = $244/nurse $244 $- • The study was scaled to 13 nurse educators Short Lecture Series Expanded Lecture Resident Training Nurse Educator Series across 7 countries in Latin America | 15
Key Factors For Hiring Nurse Educators Accelerating organization change through formalizing nurse educator program AT CHL HEADQUARTERS AT PARTNER SITES Key Responsibilities • Develop and maintain curriculum for • Customize and implement nurse overall nurse education program education curriculum • Facilitate development and • Manage PCICU quality control projects implementation of PCICU quality control • Perform data collection projects • Coordinate data collection from partner sites and provide data analysis Qualifications • Master’s Degree 1 • Master’s Degree 1 • International clinical and administrative • Clinical experience experience • Local Profile Example • Sandra Staveski, PhD, RN, PNP • Bruna Curry, MS • Jeff Paurus, MS | 16
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