• Establish infrastructure for the development of joint replacement capabilities.
• Increase knowledge of arthroscopic procedures, treatment, rehabilitation and prevention of complications.

• Improve current infection control practices to include, but not be limited to, the identification and reduction of nosocomial infections.
• Establish an effective tracking mechanism for infections, isolation procedures, and an awareness of nosocomial infections related to hospital length of stay.
• Identify immunization issues.

• Establish a Bio-medical Engineering Program for procuring and maintaining hospital equipment.
• Provide support, education and identification of bio-medical needs and personnel resources for equipment maintenance.

• Improve current EMS system through the development of an EMS training center and training program.

• Partners celebrated the launching of the partnership with a Memorandum of Understanding signing ceremony on September 20.

• Partners provided a computer network system in October for communication via E-mail and Internet.
• A Unit of Joint Endoprosthesis was established at the Donetsk Oblast Traumatology Hospital in July.

• EMS Training Center for Oblast built and equipped.
• The first EMS training course at the newly-established EMS Training Center was held In October.

• An official opening ceremony for the EMS Training Center in Donetsk was held in July.

Orthopedics

• The US partners evaluated the capacity of the operating room for conducting orthopedic surgery, observed surgical procedures and inventoried equipment needs. As a result of training received through the partnership, the NIS partners learned new techniques in joint replacement for the hip and knee and 279 joint replacement operations have been performed, as of December 2000.
• Specialized units have been set up for endoprosthesis and bone surgery, and job descriptions have been written for unit personnel. From July 1996 to October 1999, 345 endoprosthesis surgeries have been completed.

Infection Control

• As a result of a new regulation set forth by the Head Physician, two new positions for epidemiologists were established at the hospital and added to the Infection Control Committee.
• The NIS partners are now carrying out scheduled microbiology analysis of patients. Effective antibiotic therapy is being implemented. The medical staff is feeling a sense of responsibility for their work. Professional skills of both physicians and nurses have improved.
• The NIS partners observed infection control practices in both the operating room and on patient care units. They were also trained in sterilization techniques for instruments and supplies. The nursing staff at the hospital has been very involved in implementing an effective system of infection control. Six physicians and 5 nurses from the trauma hospital were trained in infection control methods in US, Great Britain and NIS.
• In 1998 the workshop in nosocomial infections was organized by Donetsk trauma hospital. The workshop was attended by 80 head nurses from Donetsk Oblast.
• According to a report submitted by the Donetsk Oblast Trauma Hospital, the average length of stay at the hospital decreased from 30.6 days in 1995 to 20,4 days in 2000. In 2000 the number of beds at the Hospital was reduced from 500 to 360.
• From 1995 to 2000, the mortality rate decreased from 2.4 to 0.7 for 10,000 treated patients.
• Data has been gathered to establish baseline status and procedures are in place to monitor these indicators on a continuous basis.

Emergency Medicine

• From October 1997 through March 2001, over 1159 physicians, nurses, feldshers and rescue personnel have been trained in pre-hospital emergency care at the EMS Training Center. Altogether 54 training courses were conducted. 26.1% of the trainees are ambulance feldshers and nurses, 25.8% - rescue teams staff, 5.2% - ambulance physicians, 28.8% - medical students and residents, 5.25 - family physicians, 3.1% - security officers, 1.98% - nurses from trauma units of the hospital.
• Partners developed an assessment tool for EMS course graduates to determine usefulness of material taught and barriers to implementation. According to the result of the tests, the knowledge and skills of the medical professionals improved by 40%, and for non-medical professionals - by 70%.
• The survey, conducted by the partners among EMS graduates, identified obstacles to the practice of the skills taught and highlighted the need for equipment procurement.
• In addition to the basic 80-hour course, the instructors of the EMS center organized outreach courses at the request of companies and enterprises of Donetsk. Thus, the instructors conducted short outreach sessions for the personnel of Donetsk chemical plant, and also organized several training sessions for schoolteachers and students.
• The Center is actively cooperating with the local media - instructors of the center demonstrate basic skills of emergency care during a special bi-monthly program on the local TV.

 
Arthroscopic Surgery

• During an exchange to Orlando, three Donetsk physicians observed sixteen arthroscopies and discussed these cases with the American surgeons. Subsequently, they performed more than twenty arthroscopies in Donetsk with the assistance of their Orlando orthopedic partners. By the year 2000, Donetsk surgeons had performed 82 arthroscopies.
• Based on an assessment of equipment needed to optimize the therapeutic and reparative arthroscopy services in Donetsk, US partners donated over $70,000 of arthroscopy equipment during 1999. The bulk of the equipment was orthopedic in nature and vital to an ongoing arthroscopy program. An infocus projector vital to the EMS training program was also delivered.
• During a follow-up trip of Orlando partners to Donetsk an additional $10,000 of orthopedic equipment will be delivered and between $3,000 and $4,000 dollars of additional computer equipment was purchased.