3 The Swansea-Gambia Link aims to: Form working partnerships between staff and students in Swansea and The Gambia to improve health care outcomes Establish a broad partnership in health - including clinical care, health service delivery, teaching and research Emphasise capacity development of staff and students involved in the Link by including education and training as part of activities wherever possibleIdentify key areas of common interest that can be developed as stand-alone projectsFocus on facilitating improved health care delivery (i.e. use teaching and training as part of broader projects to improve service delivery)
4 Visit to The Gambia September 2007 Royal Victoria Hospital, BanjulMedical School BanjulParty of 8 people from Swansea went out to establish contactsMet up with representatives from most departments
5 Visit to The Gambia September 2007 Achievements:Projects for collaboration identified:Audit supportSupport for pathology labTechnical supportStudent exchangesStimulated local discussion about future of first batch of junior doctors
6 Audit project Swansea Participants: Dr Myriam Bonduelle, Consultant O&G, ABMU TrustDr Sharon Evans Consultant Radiologist, ABMU TrustMs Sharon Morgan, Clinical Audit and Effectiveness Manager, ABMU TrustJess Griffiths, Learning technologist, Swansea Medical SchoolDr Stephen Allen, Reader in Paediatrics, Swansea Medical School and Honorary Consultant, ABMU Trust
7 Purpose of the projectThe overall aim of this project was to combine audit capacity development of a key group of health care professionals with the establishment of a means for local staff to evaluate and improve health care delivery in The Gambia.
8 Phase 1 Adaptation of Swansea training materials for use in The Gambia training in the principles of Clinical Audit to the Junior Doctors and selected nurses and midwives at The Royal Victoria Teaching Hospital in Banjul, The Gambia.
9 Phase 1Identification of local audit champions among the Senior Staff of RVTH and establishment of local audit Committeesupport the identification and development of audit projects by all the participants during the initial training, with encouragement of multidisciplinary groupscontinuous support through and internet by the Swansea team for the duration of the projects, and analysis of data.
10 Phase 1After completion of projects presentation of projects to all staff in RVTH, as well as to the Clinical Governance teampresentation of prize to best project.
11 Phase 2: Assistance with possible publication of projects. Continuing support through the local Clinical Governance Group for future audits
12 Achievements of phase 1grant was received from the Welsh Assembly GovernmentTeaching materials developed, books on audit purchasedJuly 2008: 31 participants (25 junior doctors, 4 Midwives, 2 general nurses).workshop also attended by 3 senior members of the Hospital
13 Six multidisciplinary groups formed, six projects identified: Management of severe pre-eclampsia and eclampsiaManagement of molar pregnancyStaging of breast cancerPostoperative wound careUse of the triage form in A&EManagement of advanced cervical cancer
14 AchievementsProformas designed for the projects, with identification of the standards which were to be auditedTeam leaders identifiedSenior staff members identified to provide supportCMD confirmed support for the concept
18 What happened next?Swansea team ed all the groups on return with formalised audit pro-formasFirst group of junior doctors who were generally team leaders all sent to Taiwan for further trainingPractically no further contact with any of the team members despite various attempt from usNo replies from identified senior Hospital Doctors
19 Rescue plan:Swansea students to go out during the summer holidays to attempt to complete at least one of the projects
20 Pitfalls and lessons learned Need for food during workshops! – and possibly per diemsEven though in our eyes the project was not ambitious the reality has proven otherwiseWorking life is extremely busy for local doctors – small projects would be best