Evaluating the Process and Impact of Global Health Education in a Social Accountability Perspective

: 1.044_HHR Evaluating the Process and Impact of Global Health Education in a Social Accountability Perspective V. Foley, C. Valois, P. Grand’Maison; University of Sherbrooke, Sherbrooke, Quebec, Canada, Université de Sherbrooke, Sherbrooke, Québec, Canada, University of Sherbrooke, Sherbrooke, Canada Program/Project Purpose: Global Health (GH) Education initiatives are numerous and diverse. They include initiatives for students in multiple health professions who may be at different levels of their educational pathway. They all aim to consider GH competencies in their professional disciplinary development. Competencies include a wide array of knowledge, skills and attitudes focussing on how to optimally work with vulnerable, marginalized and underserved populations, with an emphasis on equity, social justice and consideration of social determinants of health, more particularly cultural diversity. The challenge faced by program leaders is to adequately evaluate the process and impact of programs of the inclusion of GH perspective on students’ competencies, change of attitudes and ultimately on their future career pathway. Structure/Method/Design: Since 2012, the Université de Sherbrooke Faculty of Medicine and Health Sciences has progressively implemented a comprehensive process to integrate GH competencies in its programs in Medicine, Nursing Sciences, Occupational Therapy and Physical Therapy. An evaluation framework was designed by a collaborative team of GH experts, education and evaluation specialists and students. Outcome & Evaluation: The evaluation framework is built on the value of social accountability. It includes an ongoing monitoring process. This framework targets students’ development of GH competencies; follows programs’ changes and adaptation; aims to look at the influence GH education on students’ attitudes and interest to practice with vulnerable communities or patients in the future. Going Forward: The framework will be progressively implemented in future years with a scholarly approach. Major challenges will be: to adopt or develop relevant tools to reach our evaluation goals; to use the framework strategically to prioritise actions; to reinvest the evaluation results in order to improve programs and GH competencies development; to follow graduates into their practice. The development of GH education and its process and impact evaluation will contribute to the social accountability mandate of our medical school. Source of Funding: None. Abstract #: 1.045_HHR: 1.045_HHR A WHO Surgical Safety Checklist-based Infection Prevention Program in Ethiopia: Using Process Mapping to Identify Barriers for Implementation J.A. Forrester, L. Koritsanszky, N. Garland, L. Hirschhorn, S. Alemu, F. Jiru, T. Weiser; Stanford University, Palo Alto, USA, Lifebox Foundation, Boston, USA, Ariadne Labs, Boston, USA, Jimma University Specialized Hospital, Jimma, Ethiopia Background: The WHO Surgical Safety Checklist (SSCL) is proven to reduce post-operative morbidity and mortality, though it can be difficult to implement, particularly in low resource settings. Since surgical site infections (SSIs) account for substantial postoperative morbidity and mortality, we developed CLEAN CUT Checklist Expansion for Antisepsis and Infection Control: Customization, Use, and Training with two goals: (1) increase adherence to evidence-based perioperative infection prevention measures and (2) decrease post-operative infectious complications. We used process mapping of infection prevention measures to elucidate barriers to implementation. Methods: This mixed methods health services research project involves implementation and evaluation of CLEAN CUT at Jimma University Specialized Hospital (JUSH), a 432 bed tertiary hospital in Ethiopia. The Consolidated Framework for Implementation Research (CFIR) and the Interactive Systems Framework (ISF) for Dissemination and Implementation were used to develop a tailored intervention strategy of checklist introduction, baseline data collection, and interrupted time-series analysis for data processing and feedback. The checklist was introduced to clinical staff through two-half day sessions in the operating theater (OT). Data was collected in all OTs: main (3), obstetric (2) and pediatric (1). Infection prevention standards were: (i) hand & patient skin decontamination, (ii) tracking of surgical gauze, (iii) timing of prophylactic antibiotics, (iv) instrument sterility, (v) integrity of gowns and drapes, and (vi) checklist compliance. Data sources included direct observation, patient chart review follow-up (infections, reoperations, length of stay, and mortality), qualitative interviews, and process mapping of all measures.

Program/Project Purpose: Global Health (GH) Education initiatives are numerous and diverse. They include initiatives for students in multiple health professions who may be at different levels of their educational pathway. They all aim to consider GH competencies in their professional disciplinary development. Competencies include a wide array of knowledge, skills and attitudes focussing on how to optimally work with vulnerable, marginalized and underserved populations, with an emphasis on equity, social justice and consideration of social determinants of health, more particularly cultural diversity. The challenge faced by program leaders is to adequately evaluate the process and impact of programs of the inclusion of GH perspective on students' competencies, change of attitudes and ultimately on their future career pathway.
Structure/Method/Design: Since 2012, the Université de Sherbrooke Faculty of Medicine and Health Sciences has progressively implemented a comprehensive process to integrate GH competencies in its programs in Medicine, Nursing Sciences, Occupational Therapy and Physical Therapy. An evaluation framework was designed by a collaborative team of GH experts, education and evaluation specialists and students.

Outcome & Evaluation:
The evaluation framework is built on the value of social accountability. It includes an ongoing monitoring process. This framework targets students' development of GH competencies; follows programs' changes and adaptation; aims to look at the influence GH education on students' attitudes and interest to practice with vulnerable communities or patients in the future.
Going Forward: The framework will be progressively implemented in future years with a scholarly approach. Major challenges will be: to adopt or develop relevant tools to reach our evaluation goals; to use the framework strategically to prioritise actions; to reinvest the evaluation results in order to improve programs and GH competencies development; to follow graduates into their practice. The development of GH education and its process and impact evaluation will contribute to the social accountability mandate of our medical school. Background: The WHO Surgical Safety Checklist (SSCL) is proven to reduce post-operative morbidity and mortality, though it can be difficult to implement, particularly in low resource settings. Since surgical site infections (SSIs) account for substantial postoperative morbidity and mortality, we developed CLEAN CUT -Checklist Expansion for Antisepsis and Infection Control: Customization, Use, and Training -with two goals: (1) increase adherence to evidence-based perioperative infection prevention measures and (2) decrease post-operative infectious complications. We used process mapping of infection prevention measures to elucidate barriers to implementation.
Methods: This mixed methods health services research project involves implementation and evaluation of CLEAN CUT at Jimma University Specialized Hospital (JUSH), a 432 bed tertiary hospital in Ethiopia. The Consolidated Framework for Implementation Research (CFIR) and the Interactive Systems Framework (ISF) for Dissemination and Implementation were used to develop a tailored intervention strategy of checklist introduction, baseline data collection, and interrupted time-series analysis for data processing and feedback. The checklist was introduced to clinical staff through two-half day sessions in the operating theater (OT). Data was collected in all OTs: main (3), obstetric (2) and pediatric (1). Infection prevention standards were: (i) hand & patient skin decontamination, (ii) tracking of surgical gauze, (iii) timing of prophylactic antibiotics, (iv) instrument sterility, (v) integrity of gowns and drapes, and (vi) checklist compliance. Data sources included direct observation, patient chart review follow-up (infections, reoperations, length of stay, and mortality), qualitative interviews, and process mapping of all measures. Health Systems and Human Resources J a n u a r y eF e b r u a r y 2 0 1 7 : 1 8 -5 8