2016 ROTARY INTERNATIONAL CONVENTION

Moving from Community Assessment to Sustainable Strategic Plan and ImplementationMay 31, 2016

Key to Success is Simply -

Trusting Engagement and Empowerment

of Community Leaders and Members

Building a Successful Community Assessment Leading to Sustainable Strategic Plan and Implementation

Community assessment evolving into sustainable strategic plan

Steps and resources involved in prioritizing developments

Learn about entire process – Selecting participants, training

facilitators, engaging participants, final report tips, and plan adoption, updating plan process

OBJECTIVES

• Trust is key to any new or ongoing relationship

• Need to establish trust and continue to support a trusting relationship

• Trust with in-country Rotary Club and the community where a project or program is being launched

What Does Trusting Engagement Mean?

• Geographically defined

• Social unit of any size that shares common values

Community

North of Capital of Enugu in Enugu State Cultural Zone of nearly 1.4 million people; about

400,000 in city Estimated 70%-78% live in extreme poverty Site of first Nigeria University – University of Nigeria at

Nsukka (UNN) Recent attack of Fulani Herdsmen Site of one of the first battles in Nigeria- Biafran civil

war in late 1960’s– UNN destroyed; since re-built– Bishop Shanahan Hospital equipment destroyed and staffing

shattered; still recovering with additional smaller system hospitals built in Adani and Enugu-Ezike

Nsukka

NSUKKA

NSUKKA

Enugu Ezike

Nsukka

Adani

• Listening• Working with in-country Rotary Club• Identifying leaders in community• Identify leaders involved in project• Facilitating discussions; not leading• Set aside preconceived ideas and

beliefs• Help balance fact with perception in

Understanding the Community

• Local Rotary Club• Community• Example: Nsukka Healthcare Development– Nsukka Rotary Club– Local community leaders, including education and

business– Bishop Shanahan 3 Hospitals, UNN Hospital

• Administrators;Physicians; Nurses; Clinical educators; Administrative and Clinical directors and managers; Student nurses, midwifes, and med LAB

• Bishop Shanahan 3 hospitals – each of the independent boards of each hospital

LISTENING – Key to understanding

• Work with administrator to explain process• Overcoming fears of open dialogue and discussion• Rules for discussion – no right or wrong; consensus building• Leaving facilitator opinions out of

discussion; bringing in well-established facts to discussion – fine art of balance

FACILITATION

Use findings to help frame and understand the issues; but don’t let it drive the discussions

• Zero in on your community and include the surrounding community

• Conduct second hand research over internet– News and other media, Wiki, organizational information

• Publications– Research, journals

• Public Resources– WHO, Country Facts and Figures, Local information and

data, historical accounts

Understand Community – Second Hand Info

• Strategic advantage of establishing relationship with local Rotary Club – with or without a grant involved

• Visit with the Rotary Club leaders and members• Participate in their meetings and join for

fellowship• Keep them engaged and updated; ask their leader to be part of the assessment and planning process

Establish Meeting and Relationship with Host Country Club

Joint Leadership and ParticipationLeading to Wider Community Participation

Rotary Club of Nsukka Meeting

Sharing our Joint Project and Rotaryon Community Radio

• First three days of assessment and prioritizing of initiatives

• Review of assessment and planning priorities on fifth day

• Meetings on-site reviewing plan and revising as appropriate – including all key staff involved in assessment, planning process, and board members

Actual Community Health Assessment and Planning Process

Active Engagement and Empowerment

• Preparation – Process flow leading to outcomes• Question development

• Establishing seating to maximize participation

Community Assessment – Setting the Stage

• Blanks Sheets around room– Everyone contributes

• Developing local interventions to common issues – table top sheets for local engagement by organization or type of service

• Prioritizing using dots

Capturing Participant Input

Strategic Planning with administrators,physicians, nurses, laboratory technicians, nursing and lab students, finance, environmental services, social work

Participants from Bishop Shanahan, Adani,Enugu Ezike, Nursing and Midwifery Programs, Laboratory, Finance, and Environmental Services

Three-Day Strategic Planning Session

Prioritizing Using Dot Approach

Follow Up and Implementation PrioritiesNovember 17-19,2015

• Discussions with each hospital and community residents

• Prioritizing of strategic issues• Next Steps

– Finalization of Strategic Plan for July 2015-June 2020• Final report in early December 2015

– Implementation of Priorities with Leaders and Health Boards

– Ongoing communication of developments with hospital boards, staff, and community and village leaders

NSUKKA DIOCESAN HEALTH SERVICES STRATEGIC PLAN: JULY 2015 – JUNE 2020

Mission Goals Strategic Initiatives & OutcomesCommunity Health

Education and Outreach

Go To Resource for Healthcare Services

Organizational Infrastructure Support

Staffing Support

Governance and Financial Resources

Vision

Provide the highest quality health services

and healthy living information to

increase the health and well-being of the

people of Nsukka

Create and sustain the highest quality

physical, mental, spiritual, and social

well-being services and support for all

residents served by the Nsukka Diocesan Health Services

Increase voice and effectiveness on healthy living through outreach and education in church, community settings, hospitals, clinics, and schools

Partner with other providers and public and private organizations to develop and support medical education programs and coordinate public health and disease prevention messages

Develop and support services to meet the needs of the community Implement performance based programs to provide highest quality

healthcare services

Prioritize staff needs and develop plan to secure necessary equipment and supplies to effectively and efficiently serve patients

Develop a building design plan to address patient and staff needs in the hospital with short-term priority given to maternal care

Develop and implement plan for clean water, water distribution, and contaminated waste water disposal for hospitals

Develop a comprehensive plan to achieve a supportive wage and salary plan for clinical and non-clinical staff

Provide staff with on-line and local educational programming resources to increase and maintain professional clinical knowledge

Engage and support staff in ongoing multi-hospital discussions within clinical service areas on a monthly or quarterly basis

Recruit local and national health experts to serve on the Nsukka Diocese Healthcare Commission

Provide board members with performance expectations and orientation Develop and Implement a plan to ensure proper payment for services

delivered to patients, including public and private support Develop a collaborative organizational approach with other religious-based

health providers for government support and payment for patients and communities serving poverty and extreme poverty communities

Develop an approach for qualified insurers to provide health insurance plans to Nsukka Diocesan residents for usage within the Diocesan Health System

Strategic Plan Report – 20 plus pages

Drill Down on Nurse Training Program for Accreditation

• Introduction of Helping Babies Breathe (HBB)• Alternative to intubation of infant• Highly successful program • Skype and In-person• Tracking of usage of HBB• Over 60 plus went through introductory

training; 14 Nurses and Midwives Went Through Training to be certified and leads in HBB; Leads and Certified Trainers can now train others

Reducing Infant Mortality

Engagement and Empowerment

Initiating Discussions with Village leaders that identified agriculture as key issue in

Adani

Similar Approach on Agriculture Program

Initial Meetings with Village Leaders to Plan Assessment and Strategic Planning Sessions

Seek permission to speak to elders and king; village leadership attended meeting

Key to Success in Assessment, Planning, and Implementation

Trusting Engagement and Empowerment of Community Leaders and Members

Moving from Community Assessment to Sustainable Strategic Plan Implementation

Bishop Shanahan Hospital System

• Addressing:– Critical Infrastructure– Collaborative Culture for

Quality Improvement– Community Engagement – Clinical Needs– Education Programs

• Using– Global Grants– Vocational Training Teams– Club Travel Funds– Team of Advisors / Community of Interests– Clinical Experts

IMPLEMENTING SUSTAINABLE STRATEGIC PLAN: FIRST STEPS

CLEAN WATER PROJECT AT BISHOP SHANAHAN HOSPITAL

• Clean Running Water throughout Hospital, Schools, Housing

• WASH Training & Services Integration into Hospital

• Community Sales & Outreach for Prevention

CLEAN WATER PROJECT AT BISHOP SHANAHAN HOSPITAL

• Completionin 2016

• Developing Clean Water Projects for Other Hospitals

CLEAN WATER PROJECT AT BISHOP SHANAHAN HOSPITAL

• Assistance from Rotarian Architect Advisor

• Incorporate Mission of Each Facility & Sustainability

• Priorities– Labor & Delivery– Other Wards– Rehab floors & roofs– Surgical suite– Lab Tech School– Sustainable power

• Complete 1st Phase Plan in 2016

DEVELOP MASTER FACILITIES PLAN FOR HOSPITALS

DEVELOP MASTER FACILITIES PLAN FOR HOSPITALS

DEVELOP MASTER FACILITIES PLAN FOR HOSPITALS

• Assistance from TriMedX Foundation June 2016

• Make All Equipment Operational

• Build Up Hospitals’ Bio-Tech Capability

BIO-MEDICAL TECHNICIAN TRAINING

BIO-MEDICAL TECHNICIAN TRAINING

• Credentials, Governance, Facilities, Record Keeping

• Sep 1, 2016 Completion Target

DEVELOPED NURSING SCHOOL RE-ACCREDITATION CORRECTIVE ACTION PLAN

DEVELOPED NURSING SCHOOL RE-ACCREDITATION CORRECTIVE ACTION PLAN

REVAMPING DATA TRACKING & METRICS

• Understanding Cultural Differences

• Improve Local Referrals Process

• CMEs for Physicians

EXPLORE COLLABORATION WITH UNIVERSITY OF NIGERIA NSUKKA HOSPITAL

ENCOURAGING TEAMWORK FOR COLLABORATION & QUALITY IMPROVEMENT

• Encouraging:– Multi-level Teams

& Committees– Ongoing Feedback

• Clean Piped-In Water– Have to change practices

• Collaboration with Clinical Expert– Infection Control Director from Illinois (U.S.)

Department of Public Health

• Assess Current Program to Identify High Impact Items for Attention

• Need Staff Training– Safe Injection Practices– PPE Use– Hand Hygiene

INFECTION PREVENTION / CONTROL PROGRAM NEW VISION

ACTIVE COMMUNITY OUTREACH & ENGAGEMENT

• Met with Community Leaders in Nsukka, Adani & Enugu-Ezike on Mission & Strategic Plan

• Mobile Medical Units Visit Villages

• Fully Integrated Initiative for 1st Minute of Life– Created for Developing Countries

• Collaboration with Clinical Expert– Neonatologist

• Trained 60+ Nurses, Midwives, Educators– 14 becoming Certified Trainers

LAUNCHED HELPING BABIES BREATHE PROGRAM TO IMPROVE INFANT MORTALITY

Key to Success in Assessment, Planning, and Implementation

Trusting Engagement and Empowerment of Community Leaders and Members

• Pat Merryweather, dg6450pat@aol.com

• Rachel Ossyra, rachelmario@hotmail.com

Rotary Club of Naperville, District 6450

Contact Information

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