Post Heart Attack Care in India (Mark Huffman): The study aimed to develop, implement, and evaluate the impact of a quality improvement toolkit on 30-day major adverse cardiovascular event rates following acute coronary syndrome (ACS) through a cluster-randomized, stepped wedge clinical trial design in Kerala, India. System-level quality improvement initiatives in ACS, while successful in high-income countries, have not been extensively evaluated in low- and middle-income countries (LMIC), yet could be sources of innovation in the field of cardiovascular implementation science. This project leveraged the research infrastructure from the Kerala ACS Registry, which recently completed data collection from >25,000 ACS participants over the past 2 years.
Operation Smile Outcomes (Eugene Park, MD)
Dr. Park is a specialist in plastic and reconstructive surgery at Northwestern and his research followed the outcomes of patients undergoing cleft lip repair in Mumbai, India. He worked in collaboration with Operation Smile at their Guwahati Comprehensive Cleft Care Center, housed in the Mahatma Gandhi Mission Medical College. He evaluated the severity of cleft lip cases and outcomes, as well mobile follow up treatment for patients living in areas further from the hospital. Dr. Arun Gosain, Division Head of Plastic Surgery at the Lurie Children's Hospital, mentored Dr. Park on this project. Dr. Park was a finalist for the Young Investigator Award at the 2013 Wound Healing Society Annual Meeting and recipient of the Exemplary Physicianship Award during his clerkship at NU.
Northwestern Trauma and Surgical Initiative (Marissa Boeck)
This project helped develop a hospital-based trauma registry for injury surveillance, to serve as a foundation for future injury prevention strategies, to improve the safety and quality of healthcare delivered, and strengthen Bolivia’s existing emergency response and trauma system. Another goal of the project was to increase awareness of trauma and to foster local capacity for research, education and training initiatives. The project document patient information, such as basic demographics, mode of hospital transport, location, mechanisms and types of injuries and outcomes. Currently, the registry includes more than 3,200 patients, and access to the electronic database is shared with participating hospitals and local government.
Outcomes of a Novel Philanthropic-Academic Partnership to Advance Global Health in Medical Education (Ramona Bhatia)
Analysis compared total medical student global health enrollment (total international rotations completed/total medical student enrollment) at Northwestern University, Chicago, IL, before (2009-10) and after (2011-14) the development of a philanthropic-academic partnership between the Global Health Initiative (GHI) and the Center for Global Health, which resulted in centralization of financial, administrative, and educational support to travelling students. Online student post-travel evaluations starting in 2011 were also included in the study. Results indicated that the development a philanthropic-academic partnership offering comprehensive global health services to medical students increased global health enrollment, particularly at affiliated sites evaluated for academic rigor. Travel was associated with short-term knowledge gains, though these data were self-reported and lacked a control group. Presented at Unite for Sight in March 2015.
Dr. South is a General Surgery Resident who is working under the mentorship of Dr. Mamta Swaroop. He is currently living and working full time in Santa Cruz, Bolivia. He and Dr. Swaroop are working with the government to create a complete pre-hospital emergency system in Santa Cruz that will eventually be expanded to the rest of Bolivia. Features of this system include a centralized emergency call number, like 911 in the U.S., with a call and dispatch center, collaboration with public and private ambulance services, and a training program for first responders that uses a consistent medical vocabulary across emergency care providers. Describing his involvement in the program, Dr. South says, “It's really kind of amazing, because I get to directly write the legislation, design the system, meet all of the government players, write the textbooks for all the courses, teach the courses, and the list goes on.” He officially launched the program in Spring of 2017 and continuing his work with the support of the GHI.
Primeros Pasos is a community clinic providing the only consistent healthcare to the rural populations of the living in the Palajunoj Valley of Quetzaltenango, Guatemala. Recently, the clinic began to convert their operations electronically via an EHR service called OpenMRS in an effort provide more robust documentation and offer better continuity of care. Electronic tablets have been employed for the healthcare providers, with the intent of standardizing clinical questions and also to improve ease of access to patient clinical history in real-time. The study evaluated: 1) The ease-of-use of the tablet devices to healthcare providers, 2) the various fields and clinical questions that are asked within the tablet template, and 3) whether the inclusion of certain fields within the tablet lead to an increase in preventative care among the patient population.
Primeros Pasos is a low resource clinic in the Palajunoj Valley outside of Quetzaltenango, Guatemala that provides comprehensive medical, dental, pharmacy, and educational services at low or no cost. The registration system at Primeros Pasos initially consisted of electronic (excel-based) spreadsheets and a paper filing system. A sustainable EMR for the clinic with remote and local IT support was implemented that has allowed patient information to be tracked and minimizes lost, incomplete, and duplicate patient records. Average per patient timing of registration was reduced suggesting increased efficiency of registration process. Currently, staff members are continuing ongoing studies/monitoring of the new system to assess improvement and maintenance. Presented at Feinberg’s Global Health Days in September 2016.
In order to alleviate the lack of access to health care in Kacllaraccay, and in cooperation with members of the community, this project employed Community Based Participatory Research Practices to create: 1) a physical space for patients to be served and 2) a collaborative network between community health care workers (CHW), health care providers and community based educational programs that will ensure continuity of care (see Cartwright et al 2006 and Cartwright and Allotey 20067). The project took place in three phases, and was built upon two previous years of work and relationship building in Kacllaraccay and with Peruvian health care providers and advocates.