Coe q&s june 15 2011
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The document describes implementing a morbidity and mortality (M&M) conference for quality improvement at a hospital in rural Nepal. Key points: 1) The M&M conference provided a structured weekly discussion of hospital operations and patient cases among clinical and non-clinical staff. 2) Preliminary results found the conference was well-received by staff and improved understanding of case management across departments. 3) Ongoing challenges include ensuring recommendations are implemented and accountability for systems-level changes.
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Pediatrics mgr april 2011
Nyaya Health is a non-profit organization that provides free healthcare services in rural Achham District, Nepal. They work in partnership with the Nepali Ministry of Health to strengthen the public health system. Key aspects of their approach include community-based care through a network of community health workers, increasing transparency through publicly accessible data, and a focus on infrastructure development, quality improvement, and addressing challenges like limited transportation and energy resources. Nyaya Health's goal is to improve health outcomes in Achham while developing effective models of healthcare delivery for other resource-poor settings.
Nyaya Waterbury Hospital Presentation
Nyaya Health is a 501(c)(3) non-profit organization that operates a public-private partnership with the Nepali government to expand healthcare access in rural Achham District, Nepal. It aims to build healthcare infrastructure and develop a scalable healthcare model. Key accomplishments include opening the Sanfe Bagar Health Center in 2008 and transitioning to operating Bayalpata Hospital since 2009, providing free services like maternal care. Nyaya Health also works to recruit local staff, provide continuing education, and collaborate with partners like Yale to strengthen its programs.
Sar 2011_Dr. Bikash Gauchan
1) A hospital in remote rural Nepal implemented a morbidity and mortality conference (M&M) to improve healthcare quality by involving both clinical and non-clinical staff.
2) The weekly M&M meetings focused discussions on patient cases using a framework of seven domains to identify systems issues impacting care delivery.
3) Preliminary results found improved communication, a better understanding of operations, and more rigorous identification of areas for improvement across the hospital.
Kennedy presentation
This document discusses the story of Nyaya Health, a non-profit organization that builds health systems in rural Nepal. It summarizes Nyaya Health's work establishing the Bayalpata Hospital in Achham District to provide free healthcare services. The hospital has treated over 50,000 patients since opening. It faces ongoing challenges related to human resources, infrastructure, and supporting the rural public health system. Nyaya Health aims to expand services and collaborate with the Nepali government to improve healthcare access for remote communities.
Kennedy presentation
This document discusses the story of Nyaya Health, a non-profit organization that builds health systems in rural Nepal. It summarizes Nyaya Health's work establishing the Bayalpata Hospital in Achham District to provide free healthcare services. The hospital has treated over 50,000 patients since opening. It faces ongoing challenges related to human resources, infrastructure, and supporting the rural public health system. Nyaya Health aims to continue expanding services and collaborating with the Nepali government to improve healthcare access for the remote region's 250,000 residents.
Dodgers
The document summarizes a team's proposal on universal access to primary health care. The team details their coordinator, members, and contact information. It then discusses definitions of primary health care, principles of PHC, services offered at health centers, strategies to improve quality PHC according to WHO, requirements for universal access, and proposed solutions focusing on patient-provider relationships and comprehensive, equitable care.
Ruma's simons foundation talk 112809 final
Ruma Rajbhandari is a physician who trained in the US and now works in rural Nepal through the Global Health Equity Residency and Nyaya Health. She helped establish the Rural Staff Support Program through the Nick Simons Institute to address gaps in rural healthcare in Nepal. This program provides infrastructure, training, and support to rural hospitals. She now works at Bayalpata Hospital, which was renovated and is operated by Nyaya Health, to expand services and develop a scalable model of healthcare delivery for rural communities.
Nyaya Health at ANMF 2010 Conference: Telemedicine
Nyaya Health presents on Nyaya's experience with telemedicine at ANMF 2010 conference at Flagstaff, AZ.
Kate Bukowski Health Promoting Practices Presentation
The document discusses a health promoting practices quality framework and ProCare Health's strategy. It outlines how health promoting practices can improve patient health, increase patient enrollments and practice income, and reduce avoidable hospitalizations. The benefits for practices include less busy clinicians, professional development opportunities, and quality improvement. It then discusses how health promoting practices are based on overseas models and government directives in New Zealand. It focuses on integration across disciplines and improving relationships between practices, clinicians, patients, and communities. The last part outlines a five step process for practices to work on a health issue through self-assessment, using a toolkit, and quality improvement plans with support from health promoters.
Presentation to Yale Faculty
Nyaya Health provides healthcare services in Achham, Nepal where access to care is extremely limited. Current services include a health center that provides primary care, safe delivery, diagnostics, and a 4-bed inpatient ward. Community health workers do active case finding, referrals, and home-based interventions. Nyaya Health's goals are to expand primary care services, start x-ray services, and expand the inpatient ward and surgical capacities. Opportunities for collaboration include guidance on protocols, optimizing investments, and opportunities for residents/fellows in equipment procurement, surgical camps, curriculum development, and service-based research.
Introducing Advanced Nursing Practice in Oman
This document discusses the need for and benefits of advanced nursing practice (ANP) in Oman. It outlines that ANP can help address shortages in physicians by allowing nurses to take on expanded roles. ANP roles could include providing chronic disease management, health promotion, and coordinating patient care. Implementing ANP requires establishing standards, education programs, and regulatory frameworks. The document recommends establishing a national taskforce to develop ANP in Oman in order to strengthen healthcare access and quality.
Práticas Avançadas em Enfermagem no Reino Unido
A experiência do Reino Unido sobre as Práticas Avançadas em Enfermagem foi tema da última reunião virtual, que aconteceu nesta quarta (24/11), do ciclo de intercâmbio promovido pela Organização Pan-Americana da Saúde no Brasil, pelo Conselho Federal de Enfermagem (Cofen) e pelo Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem da Universidade de São Paulo/Ribeirão. As palestrantes foram a diretora e a presidente do International Council of Nurses (ICN) do Reino Unido, Melaine Roger e Daniela Lehwaldt, respectivamente. Elas abordaram os avanços globais nas práticas em enfermagem, trouxeram casos do que acontece no Reino Unido e o porquê da importância dos enfermeiros e enfermeiras em práticas avançadas para os sistemas universais de saúde.
Distance Learning for Health: Tana Wuliji
1) The document discusses human resources for health training priorities and approaches. It notes a shortage of 4 million health workers in 57 countries.
2) Training priorities include service delivery, health workforce development, use of information, supply chain management, and health management skills. Approaches discussed are workplace-based learning, distance education, and interactive learning.
3) Effective training design considers factors beyond just building competence, and must support behavior change and performance through supervision, feedback, and addressing the work environment to achieve institutionalization. Distance education alone has mixed results and works best when supported by additional strategies.
Cochrane reviews and guideline development: Is there anything new under the sun?
Cochrane reviews and guideline development: Is there anything new under the sun?Health Informatics New Zealand
Professor Cindy Farquhar
Cochrane Menstrual Disorders & Subfertility Group
NZ Cochrane Branch of the Australasian Cochrane Centre
New Zealand Guidelines Group
National Women’s Health
University of AucklandEvidencing the quality and productivity of Allied Health Professionals' (AHPs...
We recently hosted four regional events ‘Evidencing the quality and productivity of AHPs care’ with a target audience of Allied Health Professional leads in NHS provider organisations.
These slides outline sessions from the events and provide an introduction to the Model Hospital, AHP job planning and the early findings of a deployment tracker metric ‘Therapy Hours to Contacts’ that is being implemented.
Evidence of Social Accountability_Thumbiko Misiska_5.7.14
Community Score Cards were used in 10 health facilities in Malawi to improve maternal and newborn health. The process brought together communities, health workers, and local government to identify challenges and mutually generate solutions. Evidence showed improvements in key indicators like the relationship between health providers and communities. Challenges included managing emotions, constrained resources, and limited participation. Overall, the Community Score Card approach improved communication and increased demand for health services.
Nyaya Health Ultrasound Program: Implications for Teleradiology in Resource-D...
Nyaya Health operates an ultrasound program in rural Nepal to improve healthcare access for underserved communities. The program uses a portable ultrasound machine to provide point-of-care diagnostics and procedures. Initial results found it significantly changed patient management in 23% of obstetric and 40% of non-obstetric cases. Regular oversight and data review through simple teleradiology allows effective use of the technology with minimal infrastructure. The implications of the program suggest similar models could successfully utilize teleradiology for x-rays to expand diagnostic services in other resource-limited areas.
Impact Evaluation of Approaches to Strengthen Health Facility Operation and M...
This document provides the baseline results of an evaluation of approaches to strengthen health facility operation and management committees (HFOMCs) in Nepal. The evaluation aims to examine the impacts of integrating gender equality and social inclusion training and community engagement approaches into HFOMC capacity building.
Key findings from the baseline include: HFOMCs are generally perceived as inactive with unclear roles and responsibilities. Awareness of HFOMCs is low, especially among disadvantaged groups. Travel times to health facilities vary between districts and social groups. While most women rate health service quality positively, 31-40% report concerns like lack of medicines. The baseline establishes a benchmark for comparing impacts of the HFOMC strengthening interventions.
Care Coordination - Northwest Medical Partners
This document discusses care coordination in the medical home. It defines care coordination as organizing patient care activities between multiple participants to facilitate appropriate healthcare delivery. Effective care coordination involves numerous participants exchanging information and integrating care activities. The care coordination model aims to deliver the right services, in the right order and setting. Key elements of the model include assuming accountability for coordination, providing patient support, developing relationships and agreements with other providers, and improving connectivity through information sharing.
Module 1_Introduction to HC Quality.pptx
This document provides an overview of health care quality in Ethiopia. It describes the country's three-tier health system and key transformation agendas prioritizing quality. Quality is defined by the Institute of Medicine as being safe, effective, timely, efficient, equitable and patient-centered. The Donabedian framework and Juran's trilogy are also introduced as models for examining quality. Key drivers of quality improvement are identified as having the will, ideas, and capacity to execute changes.
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Nyaya Health at ANMF 2010 Conference: Telemedicine
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A Day at Nyaya-FINAL
Nyaya Hospital in Nepal provides medical care to the local community. The author describes a typical day at the hospital, beginning with morning rounds where doctors examine inpatients, many being treated for pneumonia. Afterward, doctors see outpatients and fill out cards with exam findings, diagnoses and prescriptions for patients to take to the pharmacy. In the afternoon, the author assists with prenatal care, spending time learning ultrasound techniques from the head of the antenatal clinics to measure fetal heart rate and locate the placenta.
Progress with Time
Bayalpata Hospital has undergone several renovations and expansions, including a new inpatient building with male, female, and maternity wards as well as an attached delivery suite. The clinical team provides round-the-clock care to all inpatients. Outpatient services have been expanded with four new examination rooms staffed during office hours. Emergency room facilities have also been improved with new beds and an on-call room. Additional administrative offices and a large new store room have further strengthened hospital operations and support for growing patient numbers.
A Day in the Life: GDK
Gregory Karelas is the Country Director for Nyaya Health in Nepal. He starts his day by answering emails and making plans from his office. He then has breakfast with the hospital staff in the kitchen. In the morning, he conducts a staff meeting. Throughout the day, he examines construction projects, interviews candidates, discusses landscaping and future renovations, and finalizes financial guidelines with the accountant. In the evening, he has supper with friends in the local village.
Staff presentation
This document outlines plans to improve operations at Nyaya Health facilities. It discusses proposals to enhance salary and benefits for staff, clarify procurement processes, establish clear reporting structures and complaint channels, improve housing and transportation support, revise food and leave policies, implement disciplinary procedures, increase transparency, and strengthen community involvement. The goal is to address issues and better define guidelines, policies, and processes across the organization.
Radiology rounds slideshow
The document describes a series of x-ray images taken of various patients, including a young woman with a foot fracture, elderly men presenting with heart failure and pneumonia, a woman with emphysema exacerbation, an elderly man with a history of tuberculosis now showing recurrent tuberculosis, an elderly man with alcoholic cirrhosis and extensive pulmonary disease, a man with heart failure, and a woman with renal failure and abdominal distension.
Radiology Rounds Sideshow
The document describes a series of x-ray images taken of various patients, including a young woman with a foot fracture, an elderly gentleman with heart failure and pneumonia, a woman with emphysema exacerbation, an elderly gentleman previously treated for tuberculosis now with a recurrent case, another elderly gentleman with a history of tuberculosis also now recurrent, an elderly gentleman with alcoholic cirrhosis and multiple lung issues, a gentleman with heart failure, and a woman with renal failure and abdominal distension.
Dhulikhel slideshow
The document describes various areas of a hospital including a conference room where patient discussions take place, beautiful hospital grounds, well-maintained corridors, operating theatres, pediatric wards, a medical education complex, staff and student housing, an ultrasound room, post-operative area, sterile supply room, an autoclave facility, a surgical stock room, and a post-operative supply room. It also mentions Gregory meeting with other staff.
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This document outlines over 40 powerpoint presentations given by members of Nyaya Health about their work providing healthcare in rural Nepal. The presentations cover topics such as implementing quality improvement programs, managing cases of diarrhea, introducing healthcare quality initiatives in resource-poor settings, building healthcare systems and primary care infrastructure in rural Nepal, and developing partnerships for improved global health delivery.
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Nyaya Health operates a clinic in Achham District, Nepal that provides free, high-quality healthcare using a unique model. Their model employs community health workers, is open-source and transparent, and relies on multiple sources of funding. They aim to become a teaching model for healthcare delivery and serve the underserved population. However, Nyaya Health faces challenges of growing their scale and scope while strengthening resources for replicability and creating sustainable revenue streams.
Ruma rssp qi in resource poor settings 050211
A 6-month-old boy presented to a hospital in Nepal with severe respiratory distress. Despite his poor condition, supportive treatment was delayed. That evening, a power outage caused equipment failures and the inability to provide oxygen. The child was found unresponsive hours later and died after unsuccessful resuscitation efforts. Quality improvement tools that can be used in resource-poor settings include quality committees, standards/checklists, clinical audits, patient interviews, and morbidity/mortality conferences to systematically analyze care quality and identify areas for improvement.
Ncasc fhi fhd unicef site visit 042111
This document provides an overview and review of services at Bayalpata Hospital in Nepal. It summarizes the hospital's mission to provide free healthcare with a focus on marginalized populations. It reviews the hospital's maternal health, HIV, and community health programs. For maternal health, it discusses antenatal care, delivery services, family planning and safe abortion services. For HIV, it provides data on patients enrolled in treatment and reviews challenges. For community health, it describes a partnership program with local health volunteers. The document outlines future plans to expand services and reviews budget and financing.
Mit nyaya health april 22 2011
Nyaya Health is a non-profit organization that started a hospital in rural Achham district of Nepal where there was previously no access to medical care. The organization was founded in 2006 and opened Bayalpata Hospital in 2007, which has since expanded services and now provides outpatient and emergency care, birthing services, inpatient care, testing and treatment for diseases, and community health outreach. Nyaya Health aims to prioritize the most marginalized populations and works collaboratively with the Nepali government. It relies on volunteers and donations to continue improving healthcare in the region.
Med peds noon conference feb 2011
This document summarizes a proposed prospective study to rigorously evaluate the implementation of an expanded surgical care model (IMEESC-plus) at a district hospital in rural Nepal. The study aims to 1) evaluate the implementation process using mixed quantitative and qualitative methods at the hospital, staff, and patient levels, 2) pilot an implementation research methodology for potential larger studies, and 3) generate data to inform wider scale-up of surgical care globally. Specific objectives include evaluating hospital operations and costs, staff adherence to protocols and experiences, and changes in surgical volumes, complications, and patient follow-up over time.
Martin chautari talk shefali 060509
(1) Nyaya Health provides free healthcare in rural Nepal through clinics and hospitals, operating the Sanfe Bagar Medical Clinic from 2008-2009 and currently the Bayalpata Hospital.
(2) Their model focuses on five key pillars: free healthcare for all, full transparency, working with the community and government, integrating clinical and community services, and using evidence-based medicine.
(3) Their current priorities include maternal and child health through community outreach, HIV/AIDS and tuberculosis programs, and expanding access through technology and community health workers.
Kathmandu mid town rotary
Nyaya Health is a non-profit organization that provides healthcare in rural Achham district of Nepal. It works in partnership with the Nepali Ministry of Health to build a replicable model of community-based healthcare. Nyaya Health operates Bayalpata Hospital and works with around 50 community health workers. It aims to provide free healthcare that strengthens Nepal's public health system and can be replicated in other resource-poor areas. The presentation outlines Nyaya Health's model and impact, and calls listeners to help leverage a $75,000 matching grant to further expand its healthcare services in Achham.
Idconference10 28final-091027054849-phpapp01
This document summarizes a case presentation of a patient with progressive neurological deficits and HIV. Over several weeks, the patient developed numbness that spread across his face and limbs, as well as other neurological symptoms. Imaging and spinal fluid testing did not reveal any abnormalities. A biopsy showed diffuse large B-cell lymphoma that was HHV8-positive but EBV-negative. This type of lymphoma is associated with Kaposi's sarcoma-associated herpesvirus (KSHV), which can cause various malignancies in HIV/AIDS patients such as multicentric Castleman's disease, primary effusion lymphoma, and diffuse large B-cell lymphoma.
Hsph saso presentation, dan schwarz, april 2010
Nyaya Health is a non-profit organization that aims to expand healthcare access in rural Nepal. It established the Sanfe Bagar Primary Health Center in 2008, which served over 17,000 patients in its first year. In 2009, Nyaya Health transitioned to managing the Bayalpata Hospital under a 5-year contract with the Nepali government, providing free inpatient, outpatient, emergency, and obstetric care, as well as expanding services like surgery, X-rays, and community health workers. Nyaya Health takes a transparent, data-driven, and collaborative approach through sharing operational and clinical data on its public wiki to improve accountability and allow for inter-organizational collaboration.
Hoc meeting 020111
This document summarizes the minutes from a Hospital Operations Committee meeting at Bayalpata Hospital in Nepal. It provides an overview of the hospital's programs, finances, and expansion plans. Key points include:
- Bayalpata Hospital provides free healthcare services and is managed by Nyaya Health Nepal in partnership with the Nepali Ministry of Health.
- Services include inpatient/outpatient care, emergency services, maternal care, and treatment for HIV, TB, and malnutrition. Expansion plans include a surgical suite and solar energy.
- Clinical program data from the past year show growth in services like x-rays and HIV/ART treatment. The Safe Motherhood program and community health worker network are also
Gm 2011 032711
Nyaya Health provides free community-based healthcare in rural Nepal. It was founded in 2005 as a partnership between medical professionals and the Nepali government. In 2006, one of the co-founders visited Achham district and saw extreme poverty, lack of infrastructure and healthcare access, and high rates of HIV, malnutrition and maternal mortality. While Nyaya made some progress between 2006-2011 by hiring doctors, improving roads and health spending, major challenges remained like limited electricity, long travel times for advanced care, and lack of data. Nyaya transitioned from an all-volunteer model with no paid staff to a more professional organization in order to reliably expand its operations, access more resources, and develop local healthcare solutions through partnerships
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Nyaya Health is a non-profit organization that provides free healthcare in rural Achham district of Nepal. It operates Bayalpata Hospital in partnership with the Nepali Ministry of Health. The hospital provides outpatient and emergency services, an inpatient ward, laboratory services, and community health outreach. Nyaya Health aims to strengthen Nepal's public health system and develop a replicable model of healthcare delivery. It is funded through donations and employs over 30 full-time Nepali staff. Upcoming projects include expanding surgical and community health services and increasing solar power capacity. Nyaya Health recently received a $75,000 matching grant and is seeking help leveraging additional support.
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4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
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Coe q&s june 15 2011
- 2. The Problem: Quality Chasm in Global Health Delivery “ The ease with which young people die in Achham and the ease with which it is accepted continues to horrify me.” -Ruma Rajbhandari, MD, MPH March 22, 2011 Brigham Internal Medicine Resident Global Health Equity Fellow Nyaya Health Board of Advisors Member
- 3. Study Aim To develop a systems-oriented morbidity and mortality conference (M&M) quality improvement initiative in a remote rural resource-denied setting, aimed at facilitating structured dialogue of hospital operations and identifying barriers to providing quality care.
- 4. Setting: Nepal – Achham District, Far Western Region
- 11. Results: Selection of Cases
- 23. Community Health Worker Program
- 24. Community Health Outreach Program
- 28. Inputs and Outputs Total Expenditures: $166,000 Annual Per Capita Public Health Expenditures in Achham: $5
- 29. Expenditures
- 30. Funding
Editor's Notes
- Identify where Achham is, and point out that most development, funding, tourism is in the KTM valley/east of the country – i.e. NOT the FW. Can also mention Achham (FW generally) was epicenter of Maoist conflict => even more destitution. Don’t spend more than 90 secs on this slide though, our goal is not to give a history of Nepal hehe
- “ ICU” = intensive care unit (we should spell this out for the audience as many people likely won’t know what that is)
- CHWs and CHWLs at the training session on mental health at BH.
- Wiki posited as Nyaya’s mechanism for transparency accountability & collaboration within GHD community Next slide to be posited as inter-team communication tools to facilitate GHD community TA&C DAI speaker: orgs often say “we don’t want to do that – we want to do something new… ” – Nyaya’s not trying to do anything new, we’re trying to encourage replication of the usage of technologies that are already available to enhance collaboration as a field “ 80/20 rule – 80% of what’s relevant in Zambia can be used in Malawi”