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HOPE worldwide Bolivia Executive Annual Progress Report

September 2013 – August 2014

Introduction

HOPE worldwide

Bolivia

History: The HOPE Team was planted in La Paz, Bolivia 3 years ago in September of 2011. Purpose: The purpose of HOPE in Bolivia is to support the excellent and comprehensive charitable work of Foundation and Hospital Arco Iris and to develop additional charitable initiatives. Health and Social Services: This support is focused in two different areas: Health and Social Services. In health, the focus has been around developing the income generating aspect of a sustainable social enterprise (an ambulatory clinic / (Spanish = consultorio), performance improvement within the hospital including initiatives in patient safety, quality improvement, leadership development, cultural change, focus on patient-centered care, consultation and exploration of new initiatives including traditional medicine, integrative medicine, hospice, home health, pain management, leadership development, development of nursing and more. In social services, the focus has been on the pediatric population of Hospital Arco Iris and vulnerable families. Raising awareness and funding for healthcare expenses of vulnerable children, creating and operating a part-time play and childhood development area within HAI, play therapy on the pediatric floor, creating and operating a children’s and adult library, help for vulnerable families each month and seasonally – clothing, food, holiday gifts, cleaning, organizing and education and development of an English as a Second Language course, and more. Current Staffing: Team of 10 that includes 2 full-time employees, 5 full-time consultants, 2 part-time consultants, 1 full-time volunteer.

Health

International

Medical Center

• Establishment of a for-profit ambulatory medical clinic/consultorio as part of a sustainable social enterprise for charitable activities of Hospital Arco Iris and HOPE worldwide Bolivia.

• Funding o Secured restricted donations and pledges from the USA for start-up and operational costs

until break even o We have submitted a grant proposal for an additional funding

• Advisory Board o Organized a USA based (12 members) and Bolivian-based (7 members) advisory group of

healthcare and business professionals

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• Legal o Creating legal status for a Bolivian based for-profit anonymous society o Creation not-for-profit Bolivian local foundation, Foundation HOPE worldwide Bolivia.

• Marketing o Obtained expert consultation, market research and focus groups. Produced a name, which

has been approved by the Bolivian government “HOPE International Medical Center” (in Spanish: Centro Médico Internacional HOPE)

• Equipment, Furniture and Supplies: o Obtained donations of furniture, supplies and equipment o Negotiated discounted digital radiology equipment

• Location o Suitable location found, in negotiations with the landlords

• Time Line o Anticipate opening the medical clinic in the 1st Quarter of 2015.

• Anticipated Results o Scheduled to “break-even” on or before two-years of operation, will gradually increase

revenue for charitable initiatives annually.

Nursing Assistant Program

• Developed curriculum, policies and procedures, fundraising materials • Obtained funding and pledges for start up and 2nd year costs • Exploring collaborations with Ministry of Education, Ministry of Health, Bolivian nursing schools

and accredited organizations. • With accreditation, we anticipate recruiting in the Fall of 2014 and initial class to begin 1st quarter

2015

Executive Leadership

Development

• Weekly meetings with hospital director • Coordinated consultations, training and recommendations by professional fundraiser with hospital

leaders • Coordinate consultations and recommendations by professor of business administration Group • Development, implementation and summary survey process for performance evaluations of leaders

and leadership. Individual feedback meetings with hospital director and hospital leaders • Development of monthly leadership improvement workshops with tools. Modules: change

management, performance improvement, leadership skills, teamwork, difficult conversations, cultural change, patient safety, time management, etc.

• Individual mentoring leadership meetings with hospital leadership, radiology, pediatrics, orthopedics, laboratory, emergency medicine, nursing and others

• International Collaborations for HAI Leaders - Dr. Floru, Dr. Salvieterra, Dr. Fuentes, Dr. Pasten – letters of recommendation, coordinated itinerary and partially funded experiences in the USA at academic teaching healthcare hospitals and institutions.

Medical Education of

Students, Residents

• Establishment of internal medicine, pediatrics, community based medicine and obstetrics rotations • Coordinated 5 students – including travel, housing, orientation, rotation evaluations and

communications with parent institution. • Obtained funding from teaching rotations • Partnerships with Boston, Duke, UNC, Newcastle (UK), Jefferson College – in development

partnerships with Campbell, Florida Hospital, Emory • Renewed a grant for individual and institutional license for UpToDate on-line medical resource

and education • Coordinated overseas 4 teaching rotations in cardiology (Dr. Wayar) and pediatrics (Dr. Daniela)

in Florida, Georgia and Texas

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Performance Improvement

and New Initiatives

• Patient safety/Quality Improvement – direct one-on-one consultation and mentoring of HAI patient safety officers, (Dr. Cazon, Dr. Lopez), created documents, policy and procedure, taught SAVR patient safety to HAI Interns and faculty

• Operating Room – developed a performance improvement plan and provided consultation • Hospice and Palliative Care – coordinated West Palm Beach Hospice educational materials and

consultation with HAI anesthiologist • Research – consultation/collaboration with Duke Global Health Research with Dr. Salvieterra at

HAI. • Coffee-Gift Shop – consultation/strategic plan presented to open an income generating coffee, gift

shop at HAI, in consultation with small business owner Larry and Lea Wood. • Effective Chiefs & Managers – developed a strategy for setting expectations, accountability,

disciplinary actions and rewards • Rewards and Recognition Program – consultative advice and written plan given for a rewards

and recognition plan at HAI to increase morale. • Compensation Plan – developed recommendations and model of compensation plan including

base salary and bonus incentives based on: productivity, patient satisfaction, patient safety and citizenship.

• Disciplinary Action Plan – developed documentation standards and disciplinary action plan based on levels of actions and number of occurrences

• Leadership Development – training, education and recommendations regarding balance, delegation, setting clear expectations, accountability and consequence.

• Cultural Change Strategy – recommendations regarding truly patient-centered care and setting expectations and measuring performance

• Assessment of Development of New Business – consultation and recommendations given regarding potential resources for new business development and actuarial analysis of patient populations.

• Disaster Preparedness – presented international information, consultative advice • Management of Complicated Patients – presented performance improvement document and plan • Integrity in Action – consultative advice, presented program from Duke • FODA of HAI – conducted survey of leaders, aggregated results and presented a performance

improvement action plan • International Global Health Teaching Rotations – presented a proposal for international

teaching rotations at HAI, generating revenue from teaching

International Collaboration

Faculty Professionals

• Dra. Mariel Zeccola – Pediatric Psychiatric Nursing Professional – education of nurses,

workshops, healthcare professional educational materials, donations to children’s play room and

early childhood development program

• Dr. Chris Aleman – Dermatology – telemedicine consultation, patient consultation at HAI,

lectures and workshops at HAI and UMSA, donation of electro cautery and cryotherapy

equipment.

• Dr. Chris Charon – Ear, Nose and Throat Surgeon – lecture on sinus surgery and vertigo to

ENT specialists and HAI interns and American Embassy, donations of ENT supplies.

• Dr. Rex Haydon – Orthopedic Oncology – coordinated patient consultations and referral of

patients, education of hand-surgeon

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• Dr. Carmen Graffinolo (Duke Stroke Center) and HAI Stroke Center Initiative (Dr. Floru) –

coordinated travel to Duke and meetings and procurement of equipment, monitors from Duke and

Florida Hospital

• Dr. David Boyd, Dr. Jack Mansburger – consultation regarding traditional and integrative

medicine, directly working with Dr. Goosen Lopen

• Dr. John Piette – collaborated educational workshop on depression and suicide at HAI

• Lic. Russ Hargrove – professional large gifts fundraiser, St. Jude’s Hospital – consultation,

evaluation and performance improvement of fundraising of HWWB, FAI, HAI and HWW – HSS.

Patient Care

• Dr. Broyles now seeing private patients at HAI • Private fee schedule that is generating ancillary charges, referrals, direct income, promoting the

good-reputation of HAI, generating revenue • Coordination, collaboration and transferring of international care of ex-patriot patients at HAI.

Nursing –Development

• Nursing Workshops

o Development of nursing workshops (offered at multiple times) on patient safety, culture change, new nursing forms, professional development

• Nursing Congress – Nursing Symposiums

o Spoke at off-site nursing symposium on the topic of cultural change.

o Topic - Creating a safe culture in healthcare

o Topic - The Importance of Simple Triage and Rapid Treatment

o Topic - The Importance of the Triage nurse in the Emergency Department

o Nursing presenter - National Congress for the Nursing Department of Caja Petrolera de

Salud. Topic - The Importance of the Triage nurse in the Emergency Department

o Met with PANHO to discuss opportunities for nursing education

o Presentation to Calvert School - Global International Network(GIN) group

• Management Consultation

o Consultation regarding triage improvement in Emergency Department

o Consultation to improve nurse supervision during evening and night shifts.

o Triage nurse training on START system (triaging patients)

o Provided ACLS training course w/Dr. Blanco for ER staff

o Introduction and development of Nursing Clinical Ladder

o Provided consultation and guidelines on corrective action

o Completed and implemented nursing competency assessment tool

o Created Nursing Satisfaction Survey

o Provided guidelines on principles of safe medication administration.

Social Services

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EDC

• 1467 early childhood development brochures and caregiver teaching were provided this year

Children’s Play Room

• In a response to improve patient satisfaction in the walk in clinic, a playroom/reading and

activity room was developed for children and their parents • Donations: toys • Funded part-time coordinator • Approximately 355/month children served = 4263 per year • 135 volunteers donating 3219 hours • Approximately 3219 volunteer hours

Play Therapy – Pediatric Floor

• Children’s services have been extended to the pediatric floor – offering books, toys, games and

early childhood development information to parents • Approximately 81 children per month served = 978 children per year • Approximately 67 volunteer hours per month= 807 hours per year

Hospital Children’s

Library

• The first Children’s public lending library in La Paz was created, organized and operated. • Donation: start-up donation obtained, 527 books were donated • 50 volunteer hours donated

English as a Second

Language (ESL)

• Developed curriculum, policies, procedures, internal marketing and fundraising materials • Obtained start-up funding • 1st Semester completed with 12 healthcare professionals at HAI graduating, began with 30

people. 6 classes per week for 13 weeks. • 2nd semester will begin with next level and potentially another beginning level • ESL will be offered to the community beginning in September. • Supplies and equipment obtained • Oversight and teaching - 77 hours

Vulnerable Families

• A total of 30 FAI families (184 people) served at Christmas and each month by HOPE Bolivia

and volunteers, donations of food, clothing, toys given to each family • Clothing donated to vulnerable families in rural areas • 240 volunteer hours

Vulnerable Children’s Healthcare

Fund

• Organized donations for the healthcare needs of vulnerable children and families, financially

supporting the cost of services provided by HAI.

Infrastructure Development

Supplies/Equipment

• This year, several non-monetary donations of supplies and equipment from American

Embassy(s), healthcare institutions, individual donors and subscription grants were obtained for HAI.

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Funding

• HOPE coordinated several direct monetary contributions to HAI this year.

Marketing, Blog, Media Exposure for

HAI

• Maintained a web log (blog) in English and Spanish with over 60 bimonthly articles, over 210

followers, 7,690 views (21 views per day) • Maintained active content on HOPE worldwide corporate website

o 7,582 unique viewers monthly = 90,984 unique viewers annually o 11,420 hits monthly = 137,040 hits annually

• Developed and printed two 4 page newsletters and distributed to over 2,000 donors and supporters in the USA.

• Developed a presentation for the HOPE Global Summit Long Beach, CA on professional development and Foundation and Hospital Arco Iris.

• Multiple presentations locally and abroad raising awareness of Arco Iris and HOPE Bolivia