LRC Experience in LRC Experience in Implementing Clinical Implementing Clinical Practice Protocols for Practice Protocols for Quality Improvement Quality Improvement

Lala AlievaLala AlievaJoint City Hospital #6Joint City Hospital #6

Baku/Richmond PartnershipBaku/Richmond Partnership

Date:Date:1010//0707//0303

Established in April 2000

With the overall goal to improve the health status of the Binagadi District population, including IDP/refugees, through community-based Primary Care services

The Binagadi District Health Administration in

Baku, Azerbaijan

Virginia Commonwealth University, Richmond,

VA

The Partnership

Area: 174 sq km

Population: 209 300

Health care settings 13

Health care settings in IDP/refugee communities 12

The Binagadi District

• ESTABLISHED IN FEBRUARY 2001 AT JOINT CITY HOSPITAL #6

• LAN INCLUDING 3 PCs AND INTERNET ACCESS

• TV AND VIDEO EQUIPMENT, OVERHEAD PROJECTORS

• PRINTERS AND COPIERS

• TEACHING MATERIALS

• ROOM FOR WORKSHOPS AND TRAININGS

LRS History and Facilities

• Choosing Standards

• Information Search

• Analysis

• Choosing the most acceptable Clinical Practice

• Implementation of a new standard

• Evaluation of outcomes

Strategy

• Medline

• Pub Med

• Cochrane Library

• Ovid

• National Medical Library

• Russian Health Server

• Electronic Medical Library

• The International Medical Practice Journal

Search Engines and Databases

General PracticeGeneral Practice

• Hypertension

• Gastric and Duodenal Ulcer

• Bronchial Asthma

CPGs

PEDIATRICS PEDIATRICS

• Infectious Diseases. Immunization

• Rheumatic Fever

• Bronchial Asthma

CPGs

GYNECOLOGYGYNECOLOGY

• Use of prostaglandins in the treatment of atonic and hypertonic hemorrhages

• Use of combined Femoston and Klimaktoplan therapy to mitigate manifestations of the climacteric syndrome

• Treatment of women with immune-incompatible pregnancies

CPGs

ANESTESIOLOGY ANESTESIOLOGY

• Beta-Blockers dozing principles in the most acute stage of myocardial infarction

• Action Algorithm for complicated (unsuccessful) intubations

• Revised methods of prolonged spinal and epidural anesthesia during surgeries on lower extremities and small pelvis

CPGs

SURGERYSURGERY

• Use of antibiotics and antiseptics in abdominal surgery

• Use of hyperthermia for peritonitis

• Wide use of tension methods of repair in hernioplastics for patients with giant hernias of different localizations

CPGs

• A 30% decrease in the number of patients hospitalized for arterial hypertension;

• A 20% decrease in the number of patients hospitalized for aggravations of gastric and duodenal Ulcer;

• A 15% drop in the number of complicated deliveries;• Controlled bronchial asthma status achieved in 70% of the BA patients;• A one-third decrease in the number of complication and mortality cases

in Joint City Hospital #6 Intensive Care Unit.• About 65% of physicians and health workers surveyed said that the use

of new clinical practice guidelines had assisted them in making the treatment more efficient.

• The percentage of patients assessing the quality of medical care that received as “good” and “very good” increased from 20% to 65%.

Outcomes