Making a difference

1. Making a difference
Dan Ritman
Quality & Learning Manager, THET
Elizabeth Rafii-Tabar
Global Health Projects Manager,
Centre for Women’s Global Health, RCOG
October 2017

3. Patients and carers
Worbury health workers
Kakura health workers
Kakura hospital management
means “leads to”

4. Health partnership between Worbury Hospital NHS Trust, UK and Kakura District Hospital, Kenya. Project to improve care of stroke patients.
Kakura nurses and
physiotherapists lack
stroke care
knowledge and skills
Worbury nurses and
physios and Kakura
doctor design stroke
care training course
Worbury nurses and
physios visit Kakura to
train counterparts
and work with doctor
on stroke protocols
Kakura project lead
seeks managerial
support and resources
for new stroke ward
Kakura nurses and
physiotherapists have
stroke care
knowledge and skills

5. Health partnership between Worbury Hospital NHS Trust, UK and Kakura District Hospital, Kenya. Project to improve care of stroke patients.
Kakura nurses and
physiotherapists lack
stroke care knowledge
and skills
Worbury nurses and
physios and Kakura
doctor design stroke
care training course
Kakura nurses and
physiotherapists have
stroke care knowledge
and skills
Worbury nurses and
physios visit Kakura to
train counterparts and
work with doctor on
stroke protocols
Kakura project lead
seeks managerial
support and resources
for new stroke ward
Improved
recovery
from stroke
Kakura stroke care
protocols devised
Kakura clinicians
provide improved care
to patients on stroke
ward
Kakura clinicians
educate stroke
patients’ families on
providing care at
hospital and after
discharge
Worbury clinicians use
teaching experience in
NHS
Patients’ families
provide improved care
and support
New stroke ward
established

6. Patients and carers
Worbury health workers
Kakura health workers
Kakura hospital management
Barriers
means “leads to”

7. Health partnership between Worbury Hospital NHS Trust, UK and Kakura District Hospital, Kenya. Project to improve care of stroke patients.
Kakura nurses and
physiotherapists lack
stroke care knowledge
and skills
Worbury nurses and
physios and Kakura
doctor design stroke
care training course
New Med Super refuses to provide
resources and space for stroke
ward
Kakura nurses and
physiotherapists have
stroke care knowledge
and skills
Worbury nurses and
physios visit Kakura to
train counterparts and
work with doctor on
stroke protocols
Kakura project lead
seeks managerial
support and resources
for new stroke ward
Improved
recovery
from stroke
Kakura stroke care
protocols devised
Kakura clinicians
provide improved care
to patients on stroke
ward
Kakura clinicians
educate stroke
patients’ families on
providing care at
hospital and after
discharge
Worbury clinicians use
teaching experience in
NHS
Patients’ families
provide improved care
and support
Kakura clinicians lack skills /
motivation to educate
families
Poorer patients’
families cannot afford
to visit / support them
Kakura clinicians are transferred to
another hospital; or they lack
resources to provide stroke care
New stroke ward
established
Kakura clinicians
forget key
knowledge and
skills

8. Patients and carers
Measures
Worbury health workers
Kakura health workers
Kakura hospital management
Barriers
means “leads to”

9. Health partnership between Worbury Hospital NHS Trust, UK and Kakura District Hospital, Kenya. Project to improve care of stroke patients.
Kakura nurses and
physiotherapists lack
stroke care knowledge
and skills
Worbury nurses and
physios and Kakura
doctor design stroke
care training course
New Med Super refuses to provide
resources and space for stroke
ward
Kakura nurses and
physiotherapists have
stroke care knowledge
and skills
Worbury nurses and
physios visit Kakura to
train counterparts and
work with doctor on
stroke protocols
Kakura project lead
seeks managerial
support and resources
for new stroke ward
Improved
recovery
from stroke
Kakura stroke care
protocols devised
Kakura clinicians
provide improved care
to patients on stroke
ward
Kakura clinicians
educate stroke
patients’ families on
providing care at
hospital and after
discharge
Worbury clinicians use
teaching experience in
NHS
Patients’ families
provide improved care
and support
Kakura clinicians lack skills /
motivation to educate
families
Poorer patients’
families cannot afford
to visit / support them
Kakura clinicians are transferred to
another hospital; or they lack
resources to provide stroke care
New stroke ward
established
Kakura clinicians
forget key
knowledge and
skills
OSCE of clinicians’
management of stroke
patients, three months
after training
Change in average
functional
assessment score
at discharge
Kakura Med Super
explicit approval of
protocols
Patients’ families
express more
confidence in their
knowledge of carePre- and post-
training test scores Health workers’
observations of
caring practices
Annual supervision
recognises
improved
competency