Neonatology

Surgery

Infection Control

Nursing

Administration

1992

1993

1994

1995

1996

1997

1998

Infection Control

• An Infection Control Committee was created at the Odessa Oblast Hospital (OOH) early in 1996; the committee meets monthly to discuss infection control related issues. All heads of hospital units are required to report all cases of infection complications to the hospital Infection Control Committee.
• Within the framework of Infection Control Program, the senior duty nurse is responsible for supervising both nurses and physicians in respect to compliance with Infection Control regulations.
• In May 1996 the positions of epidemiologist and deputy epidemiologist were created at OOH, including duties and responsibilities for each position.
• The OOH has implemented rational antibiotic therapy protocols.
• As a result of basic and advanced infection control training, OOH reported a reduction of surgical site infection rates by 35 percent.
• Since the inception of the infection control program, the occurrence of post-operative infectious complications decreased by 50 percent and the post-operative average length of stay was decreased by 3.5 days. The chart below demonstrates the decline of the average length of stay and other surgical statistics over the last four years of the partnership.

  	1994	1994	1995	1995	1996	1996	1998
  Parameters	Odessa Oblast Hospital	Average in Ukraine	Odessa Oblast Hospital	Average in Ukraine	Odessa Oblast Hospital	Average in Ukraine	Odessa Oblast Hospital
  Total number of succesfully treated patients	27,147		27,600		28,198		32,500
  Average length of stay	14	18.4	13.88	16.85	13.19	15.37	10.9 (best in Ukraine)
  Total number of operations	8,604		9,254		9,283		9,875
  Mortality level	1.4	1.5	1.29	1.13	1.35	1.41	1.2 (best in Ukraine)

• As a result of the strides made in the area of infection control at the OOH, AIHA and the developers of the WHONET program chose OOH as one of six pilot sites. Beginning in July 1997, work began toward upgrading their microbiology laboratory, gathering data on resistance to antimicrobial agents, and, based on the data analysis, implementing mechanisms to minimize the misuse of antimicrobial agents.
• OOH implemented an active focused infection control surveillance program in 1998.

Surgery

• From the inception of the partnership through 1998, over 2,000 laparoscopic procedures have been completed by the surgeons at Odessa Oblast Hospital (OOH).
• Six surgeons from OOH have become experts in laparoscopy, and laparoscopic cholecystectomy is now performed as a standard procedure in 73 percent of patients with cholecystitis. Since the inception of the program over 1,300 laparoscopic cholecystectomies have been performed. As a result of all the improved surgical techniques, there has been a reduction in average length of stay for cholecystectomies from 11 days to 3.8 days.
• The OOH was the first hospital in Ukraine to perform laparoscopic vagatomy.
• The hospital-wide reduction in the length of stay has been reduced from 12 days to 5 days and the average length of stay in the surgical department has declined from 14 to 10.5 days.
• As a result of partnership training in new surgical techniques and technologies, hundreds of surgeries have been successfully initiated and performed at OOH. These include laparoscopic and endoscopic surgeries (such as endoscopic papillotomy; ultrasound-controlled hepatic, peritoneal and kidney cystectomy; and balloon gastric dilation); vascular and thoracic surgeries (such as video-controlled lung and pleural thoraxoscopy, and new laser techniques in thoracic surgery); urology surgeries (such as transurethral resection of prostates and internal urethrotomy).
• A new professional society, the Ukrainian Association of Laparoscopic Specialists, was formed in Spring 1997. The Association serves to provide education in laparoscopic procedures to all regional hospitals. The Chairman of the Association is a physician at the Odessa Oblast Hospital who has received extensive training in laparoscopic surgery at Coney Island Hospital.
• The Ukrainian National Association for Endoscopic, Laser and Minimally Invasive Surgery (UNAELMIS) has been established at Odessa Hospital.

Women's Health

• The Head Physician of the Odessa Oblast Hospital created a Mammography Project Technical Group (MPTG) in fall 1997, which is composed of himself, the Director of the Women's Wellness/Breast Care Center, the hospital's chief engineer, senior electrical engineer and senior plumbing engineer, two radiologists, other radiology staff and several US partners.
• The Head Physician from OOH was a member of the committee that created the breast health section of the clinical practice guidelines reference manual being used in each of the AIHA-sponsored Women's Wellness Centers.
• The US and Ukrainian partners have established a process by which the radiologists at OOH will send at least ten mammography films per month (plus other questionable films) to their colleagues at Coney Island Hospital. This system of second reads will serve as a quality assurance program for identification and diagnosis of non-palpable lesions in the breast.
• Partners established a comprehensive Women's Wellness/Breast Health Center in OOH in November 1998. Based on AIHA's Women's Wellness model, the center provides early prenatal care and childbirth classes; breastfeeding education; cancer screening; internal referral for mammography; substance abuse and alcohol abuse prevention education; mental health education, counseling and support; screening education for chronic diseases like hepatitis, hypertension, diabetes, anemia.

Administration

• The director of primary care at OOH implemented a number of administrative and market-reform changes since visiting Coney Island Hospital.

Nursing

• The newly implemented team approach allowed nurses to clearly understand their role in the effective treatment of patients and to begin playing an active role in therapy and treatment. Nurses demonstrate greater interest in the state of their patients as they now view themselves as important and responsible participants in healthcare.
• Approximately 900 nurses received professional training through the seminars, conferences, workshops and meetings sponsored by the partnership. Nearly 2,000 medical professionals have participated in regional conferences sponsored by the partnership.
• The partnership has established an Odessa Oblast Nursing Association at OOH for nurses in the region; the association has approximately 400 members.

Neonatology

• Since the opening of the Odessa Neonatal Resuscitation Training Center in February 1998 through the end of 1998, approximately 450 physicians (ob/gyns, neonatologists, anesthesiologists and pediatricians), nurses and midwives have been trained in neonatal resuscitation.