Primary Care

• City Polyclinic #15 was acknowledged by the Russian Ministry of Health as an example of successful innovation in the area of primary care. The minister of health presented the polyclinic's chief physician with an award for outstanding achievements in the provision of health care.
• Changes implemented in patient care protocols at Polyclinic #15 resulted in substantial savings in costs due to a reduction in hospitalizations.
• Patient satisfaction surveys were developed and used by Polyclinics #9 and #15 in 2003. The Russian partners began to use the information to make management decisions and a second round of surveys is planned for 2004.
• The patient satisfaction surveys conducted in October 2002 were analyzed; results demonstrated increased patient satisfaction and acceptance of reforms in the primary health care system. The partners added an on-line questionnaire to assess patient satisfaction with services offered on the polyclinic website.
• A Family Medicine Center at Medical Unit #2 was opened in Samara in March 2002. The center serves an isolated and poor population of 1,700. Specific technical training was provided by the partners to the chief physician and clinic nurses.
• Partners assessed existing programs in Samara for diabetes, at-risk families, women and adolescent health, and sexually transmitted diseases (STD) and created training and additional programming.
• Patient education schools at the Samara Polyclinic #15 and general practice office of Polyclinic #9 were established for patients with arterial hypertension, asthma, and diabetes. Over 100 patients have been enrolled in each of the schools, guidelines developed, and educational materials developed and distributed.
• Polyclinic #15 established a school for persons with glaucoma and cancer.

Women's Health

• Two Women Wellness Centers (WWC) at Polyclinics #9 and #15 were opened in March 2002. The Centers provide a variety of services such as family planning, school for future parents, and STD prevention program. The Centers serve a female population of 34,000.
• The maternity house at the Samara Oblast Clinical Hospital, whose medical personnel received training at the Samara Neonatal Resuscitation Training Center, was named a baby friendly hospital by the World Health Organization (WHO).
• Patient education, breast health screening programs, and reproductive health education and counseling programs were created.
• Young Fathers and Young Mothers schools that include Lamaze training were created at the WWCs.
• A program for peri and postmenopausal women, “Golden Fall”, was established at the WWC at #15.

Domestic Violence

• The partnership hosted a region-wide domestic violence conference in 2001 as part of its work with vulnerable populations.
• The Samara Women's Wellness Center at Polyclinic #15 began primary screening for domestic violence among patients. The screening starts with a patient registration form that was modified from a sample presented at the AIHA Women's Health and Dissemination Conference in December 2001. Physicians provide counseling and/or refer patients to local crisis centers as appropriate.

Long Distance Learning

• The Samara Learning Resource Center (LRC) and its healthcare database are considered models and the Samara partners often host tours and demonstrations. During the past three years the LRC has trained over 300 clinicians a year in the use of computers and the Internet.
• All partnership delegations to Iowa received an orientation and training program on accessing the Internet and locating clinical and management information.
• The US partners continued their work on the production of training videos for Samara. Several programs were video recorded and the Russian language track added. The videos were be transmitted to the LRC in Samara where they were copied onto compact discs and distributed to local clinics. The quality and value of this method of distance learning continues to be evaluated.
• The Medical Information and Analysis Center (MIAC) in Samara received a grant from the Social and Cultural Projects Fair, “Nizhny Novgorod 2003” funded by the Volga Region Federal District. The grant, approximately $29,000, is to support the development of a regional information center and an interregional partnership for the prevention of drug abuse.

Nursing

• Nurse educators and state health department officials from Iowa conducted training programs for nurses in physical assessment and seminars in ethical dilemmas and patient confidentiality during their September 2000 exchange to Samara.
• In November 2000, a delegation of nurses from Samara focused on nursing education and training for the delivery of services in a family medicine setting, especially on the relationships between physicians, nurses, and patients in treatment and patient education. Medical supplies were purchased for the nurses at polyclinic #9 and #15.
• Nurses from Samara were trained in Iowa on delivery of family medicine services and patient health assessments, emphasizing the relationships between physicians, nurses, and patients in treatment and patient education.
• Substantial reallocation of responsibilities has occurred at Polyclinic #9 and #15. Previously, only physicians could make home visits to chronic patients, but nurses now also fulfill this role.
• Training on patient health assessment was conducted for the nurses during their exchanges to Iowa in April and June 2002 and training by Samara health care professionals was implemented as a continuing education program.
• In March 2004 the nurses from Polyclinic #15 hosted a conference for nurse administrators and general practice nurses from the municipal and oblast hospitals and polyclinics. Many subjects were presented, but the most often demanded is the physical assessment training created by the partners.