Global Recognition and Assessment of Sick Patients and Initial Treatment - GRASPIT

1. Global Recognition and Assessment of Sick
Patients and Initial Treatment
GRASPIT
Lessons in sustainability
Dr Mary Ibeto
Torbay-NRCK Partnership

2. Global Recognition and Assessment of
Sick Patients and Initial Treatment
 One day course
 In Kenya from 2009
 Co-developed
 In response to need
 Lecture and scenario
 Simple equipment
 NRCK Accredited 2012

3. GRASPIT
4 core principles:
- Early recognition of acutely unwell patients
- Systematic approach to the assessment of
acutely unwell patients
- Early initial treatment
- Team working through effective communication
It as easy as...A B C D E

5.  Partnership between Torbay Hospital and National
Resuscitation Council of Kenya
 THET HPS grants
 GRASPIT local support network:
- faculty of Kenyan master trainers
- leadership roles for training coordination and M&E
 3 day induction process followed for each new
institution
GRASPIT Scale up

6. GRASPIT Induction Process
Day 1
GRASPIT One Day
Course
• 25-30 GRASPIT
Trained
• 10 GRASPIT
Trainer Elects
Day 2
GRASPIT Training
of Trainers Course
• 10 GRASPIT
Trainers
• GRASPIT
Champions
Day 3
GRASPIT One Day
Course
• 25-30 GRASPIT
Trained
• GRASPIT
Training
Agreement

7.  >2000 health care staff GRASPIT trained
 120 GRASPIT Trainers
 22 Master Trainers
 All Kenyan Faculty
 10 Kenyan Hospitals
 6 Counties
 Local funding commitment
Achievements

8. Initially training were not sustained between UK
team visits
Locally identified roadblocks:
- inconsistent funds for training
- competing tasks for faculty members
- staff turn over
- lack of commitment from some trainees
- lack of commitment from some faculty members
Challenges

9. Training needs analysis conducted to identify:
- institutions that would benefit from GRASPIT training
- institutions willing to take on ongoing responsibility for
GRASPIT delivery
Trainer fatigue avoided by ensuring a critical number
of trainers where developed in each institution
Local trainers supported through:
- regular quality assurance visits
- development opportunities
Overcoming the challenges

10. GRASPIT aligned with county and national agendas
- Kisumu Emergency Care Framework  funding
commitment (KSH 1.5 million) for GRASPIT training hub
- Kenyan Quality Management Framework  Kenyan
MOH endorsement of GRASPIT
Motivation to restart training driven by:
- GRASPIT meeting identified strategic need
- Peer support through the GRASPIT network
- Low cost
- Universality
Overcoming the challenges

11. Not Sustainable
• Driver from outside the
system
• Dependent on provision of
external resources
• Time bound project
• Dependent on specific
individuals
• Project is linked to named
persons
• Few locations and involving a
few individuals
Sustainable
• Driver exists within a system
• Deliverable with resources from
within a system
• Part of regular planning cycle
• Dependent on defined roles that
can be potentially filled by anyone
with the correct skill set
• Numerous locations
• Has achieved a critical mass

12. Key lessons in sustainability
Scale up process and sustainability are closely interlinked
For scale focus is at an individual staff member level
For sustainability, the focus is more on integrating the course into
the health system and creating the conditions that favour:
- alignment to regional and national policy
- setting expectations at outset that it will be handed over for local
delivery
- encouraging and supporting allocation of local budget
- creating ownership at institution, regional and national level
- creation of support network based on defined roles

13. Thank you

14. More information / Contact us
Visit GRASPIT Kenya website
www.graspitkenya.com
Email us on
info@graspitkenya.com