GC4 Medical Programs: Strategic Plan Summary, June 2014

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GC4 Update September Medical Programs 2011

Goals and Strategic Plan

Scalable, Sustainable, and Cost-Effective Surgical Care

Namaskar It is our pleasure to update you on the Guwahati Comprehensive Cleft Care Center. This unique public private partnership is making daily progress towards achieving our goals of Increased Capacity, Decreased Costs, and a Cleft Free Assam. September has been another month full of progress and evolution at GC4, and we very much hope you enjoy this update. --Team Guwahati June, 2014


GOAL #1:

SURGICAL EXCELLENCE

To be one of the highest volume cleft centers in the world with anesthesia and surgical outcomes rival those in the developed world.

Total Surgeries May 2011-­‐May2014

ü 100% local Leadership: Surgery, Anesthesia, Nursing ü 16 medical staff internationally credentialed with OS and 10 regionally credentialed

ü 4 GC4 Surgeons appointed: Clinical Assistant Professors of Surgery ü

International Rotations to Centers of Excellence: (Surgery 6; AN 2; Nursing, Dental, Child Life, Pt. Care 1)

ü Visiting Professors Program hosts top international authorities: Plastic Surgery: Dr. Bill Magee (Operation Smile, USA) Dr. Don Mackay (Penn State University, USA) Dr. Ron Zuker (SickKids Hospital, Canada) Dr. Greg Borschel (SickKids Hospital, Canada) Dr. Arun Gosain (Lurie Children’s Hospital, USA) Dr. Jan Lilja (University of Gothenburg, Sweden)

Pediatric Anesthesia: Dr. Peter Radell (Karolinska Hospital, Sweden) Dr. Chris Cressy (Karolinska Hospital, Sweden) Dr. Peter Frykholm (Karolinska Hospital, Sweden) Dr. George Politis (University of Virginia, USA)

p p p p p p

Dr. Henry Kawamoto (UCLA, USA) Dr. EJ Caterson (Brigham and Women’s / Harvard, USA) Dr. Joe Williams (Atlanta Children’s, USA) Dr. Jesse Taylor (CHOP, USA) Dr. Detlev Erdmann (Duke University, USA) Dr. Krishna Rao (PS, Maaya Foundation, India) Dr. Sunil Richardson (PS, Richardson’s Hospital, India) Dr. Peter Radell (Karolinska Hospital, Sweden) Dr. Chris Cressy (Karolinska Hospital, Sweden) Dr. Peter Frykholm (Karolinska Hospital, Sweden) Dr. George Politis (University of Virginia, USA)

Advanced Skills Development Enhancement and Diversification of Surgical Services Evolution of Medical Leaders Surgical Outcomes Program Regional Referral Center for NE India Increased Outreach Missions from GC4


GOAL #2:

COMPREHENSIVE CARE

To be at the forefront of innovation in order to conquer the challenges of real multidisciplinary care for children in in the developing world.

Speech Therapy (2013-­‐2014) Patient Education Materials Developed § Home Therapy Manuals § Home Therapy Videos § Home Therapy Materials Packages

Dental and Orthodontic s Expansion and Evolution o f Services § Orthodontics program initiated with local cleft orthodontist § Nasoalveolar molding (NAM) has been performed > 50 patients

Child Life and Nutrition § Perioperative services and counseling to 100% of patients and families § > 500 patients have “graduated” from the GC4 nutrition program and received successful operations.

p Speech Therapy Outreach Centers, with GC4 speech therapists training and supporting local resource teachers as ST extenders. p Dental Outreach Program for treatment and patient education p Guwahati-­‐NAM (G-­‐NAM) device prototyped in partnership with Croleon Innovation Labs in Pune to provide more effective presurgical molding p Advanced skills development of multidisciplinary specialists p Development and evolution of Orthodontics Program. p Pilot project funded (USAID and Dimagi) uses cellphones to follow nutrition patients by partnering with ASHA’s to collect data and send to nutrition team at GC4 for monitoring.


GOAL #3:

EDUCATION & TRAINING

To be a center of education and training that will serve as a central resource for human resource development for Operation Smile and the hub for an ever-­‐ expanding network of centers and missions.

Education, Training, and Research Rotations at GC4

*

ü 127 rotators from 15 (+) countries have come to GC4 specifically for participation in education, training, and research and involving all medical divisions. ü International rotations in Surgery, Anesthesia, and Nursing formalized and accepted for credit by home education institutions. Excellent engagement of students / trainees in research. ü 41 visiting professor rotations have taken place at G C4, with professionals representing 20 institutions from 5 countries. ü Advanced skills workshops in rhinoplasty, velopharyngeal insufficiency, orthognathic surgery, difficult airway. ü The International Conference on Comprehensice Cleft Care w as held in Guwahati in November, 2013 and included professionals and stakeholders from 22 countries.

Cleft Surgery Training Program ü ü ü

First four fellows selected (India, DRC, India, Malawi). Rotation to SickKids, Penn State, and Operation Smile HQ. Full curriculum online at www.cleftacademy.com.

Cleft Anesthesia Training Program ü ü ü

First fellow (Bolivia) to b egin July, 2014. Rotation to SickKids, Penn State, Operation Smile HQ. Full curriculum finished.

February 6-8, 2015

ü AHA training site ü 5 certified AHA instructors ü 260 BLS ü 60 ACLS ü 135 PALS

Cleft Nursing Training Program p Anticipated launch January, 2015

Child Life Training Program

p Anticipated launch October, 2014

Gap Year Student Program

p Anticipated launch January, 2015


RESEARCH & OUTCOMES

GOAL #4:

To be a center of research that takes advantage of its volume and expertise to offer the academic literature data that will redefine best practices in care.

ü Structured Division of Research & Outcomes ü OS India IEC provides ethical oversight

ü Research collaborations with numerous academic partners: § § § § § §

Harvard Global Health Institute Harvard Dept. of Global Surgery Brigham and Women's Hospital Boston Children’s Hospital Karolinska University Hospital University of Southern California

§ § § § § §

Penn State University SickKids Hospital Emory University University of Pennsylvania Denver Children’s Hospital Universidad Autónoma de Barcelona

ü Awarded lead articles in special edition of the Journal of Craniofacial Surgery (September, 2014) focused on cleft surgery in India.

p p p p p

Evolve and Enhance Partnerships Dedicated Research Staff Grants and Funding Database Optimization Surgical Outcomes Program

§ § §

§ § §

University of British Colombia University of Vermont London School of Economics Croleon Innovation Labs Operation Smile International Operation Smile India


GOAL #5:

ORGANIZATIONAL OPTIMIZATION

To use advanced medical technologies, IT applications, management strategies, and resource utilization to provide the best treatment available to the highest number of patients possible.

ü Success of Public Private Partnership Model ü Innovative Patient Mobilization Strategies and Patient Counselors Program

ü Productive Organizational and Management Structure ü Innovative Patient Care Processes have provided more than 16,000 screening examinations, 11,000 surgeries, and 13,000 follow ups in Assam since 2009.

ü Comprehensive Policies & Procedures

ü Proven Patient Education Programs ü Quality Assurance, Continuing Medical Education, Morbidity & Mortality, Journal Club


ü GCCCC model proven to be very cost effective while investing 92% of expenditures into local workforce, infrastructure, and economy.

p Telemedicine for global teaching in cleft care. p Enhanced education materials. p Electronic medical record. p Data and PIT photos to iCloud. p Social media to engage partners and supporters. p Expanded and enhanced physical infrastructure with 3rd floor addition.



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