Maternal and Child Health

• Hold symposia on Obstetrics, Gynecology and Neonatology at SPMU.
• Introduce endoscopy to OB/GYN physicians.
• Enhance neonatologists' skills in antepartum and intrapartum fetal monitoring.
• Enhance skills and the care of premature and sick infants; increase skills in caring for complicated obstetrics cases.
• Train OB/GYN physicians in laparoscopic surgical procedures and in new techniques for anesthesia.
• Enhance the learning experience of SPMU nurses working in the Labor and Delivery Unit by introducing principles of fetal and uterine monitoring.

Ophthalmology

• Improve the quality of ophthalmic care focusing on the use of minimally invasive procedures to enhance care, decrease length of stay, and decrease the number of complications for ophthalmologic patients.
• Develop alternatives to inpatient surgery and care.
• Introduce techniques to decrease incidence of cataract recurrence.
• Introduce nurse/assistant support of physicians in surgery and pre-operative procedures in order to: increase number of procedures per time period; decrease patient waiting time; increase opportunities for post-operative home care; and increase the inpatient population served.
• Train SPMU ophthalmologists on vitreous retinal (posterior chamber) surgical procedures.

Urology and Endoscopy

• Improve the quality of care in urology focusing on the use of minimally invasive procedures to enhance care, decrease length of stay, and reduce the number of complications for urological patients.
• ITrain SPMU urologists on laparoscopic procedures.
• IProvide training in the treatment of incontinence, bladder reconstruction, male infertility, and radical prostatectomy for cancer.

Hospital Administration and Finance

• Improve efficiency, cost-effectiveness and quality of care by introducing various concepts of financial management and hospital administration.
• Develop methodology for coordination of OB/GYN program and teambuilding.
• Familiarize managers with concepts of financial management, computer applications, and product line management.
• Acquaint two department chiefs with programs and systems designed to reduce infection and maintain a safe, clean environment.
• Develop alternative funding sources in the event that USAID support ends. Explore the possibility of establishing a charitable foundation at SPMU to this end.

Nursing Education

• Improve the clinical nursing program at SPMU in coordination with the College of Nursing.
• Develop a clinical nursing model adapted to conditions and to legal requirements in St. Petersburg.
• Develop curriculum for College of Nursing at SPMU to include a practicum.
• Familiarize nursing administrators/managers with concepts of structure, process and outcome.
• Evaluate program and services to reduce infection.
• Develop a "train-the-trainer" educator course for select faculty that would focus on patient education. Establish a nursing student exchange between Atlanta and St. Petersburg.

Radiology

• Train radiologists in the operation, use, interpretation, care and precautions with computerized tomography (CT).
• Develop telemedicine capability using Winrad program to transmit CT scans in order to conduct international consultations over the Internet.

Information Technology

• Create an infrastructure for introducing new information technologies and training personnel in their use.
• Connect SPMU to the Internet and establish Internet services (electronic mail, home pages, FTP server).
• Make information resources available for the University employees' collective use and train personnel in using information resources.

Family Physicians In 1999 the partnership received additional funding to focus on the following additional objectives:

• To assist family practice physicians at SPMU to organize, develop, and implement a fully-integrated primary health care delivery system. This would become a fully developed unit of SPMU and part of their teaching program.
• To develop an educational curriculum for primary care. To write a policy/procedure manual, to develop charts of accounts with associated fee structures, to develop clinical pathways that are readily implemented and an indicator system that would lead to outcomes measurement.

• The partners hosted an International Symposium on Obstetrics and Gynecology at Pavlov for NIS clinicians. Formal presentations and hands-on workshops addressed the management of complex obstetrical patients, endoscopic procedures, and reconstructive techniques following oncological surgery. 400 nurses and physicians attended from the NIS, the United States, Germany and Austria. At this time the US partners donated $40,000 in vaginal ultrasound equipment.
• The partners conducted a telemedicine conference in St. Petersburg with the assistance of Turner Broadcasting Service. Partners transmitted medical information and images between Sokolov Medical Center (then a partner of Georgia Baptist as well as Jewish Hospital Healthcare System) and Georgia Baptist.
• The Georgia Baptist partners donated $50,000 for renovations to SPMU.

• On January 10, the partners celebrated the signing of the Memorandum of Understanding between Georgia Baptist Healthcare System and Georgia Baptist Medical Center on the US side, and SPMU in Russia.
• The partners hosted a seminar on financial reporting, patient classification systems, and strategic planning. Hospital administrators, accountants, insurance company representatives, physicians and medical students from throughout the St. Petersburg area attended the seminar. As a result, partners developed a strategic plan for SPMU.
• A physician from Atlanta delivered, installed, and conducted training in the use of a microscope donated by Georgia Baptist for vitreous-retinal surgery.
• The Chief Medical Advisor to the Mayor of St. Petersburg and the First Deputy Chairman of the St. Petersburg Public Health Committee visited partners in Louisville and Atlanta. They also traveled to Washington, DC to express their satisfaction with the partnership program to members of Congress from Kentucky and Georgia.
• A Learning Resource Center (LRC) was established at SPMU as part of AIHA's LRC project. Partners designated an information coordinator and received essential computer equipment and training from AIHA.

• The partners held an endosurgery symposium in St. Petersburg focusing on obstetrics and gynecology. The US delegation brought with them three fetal monitors, and much of the symposium and clinical work focused on the use of these monitors.
• Together with the Atlanta-Tbilisi partners, the Atlanta-St. Petersburg partners hosted AIHA's Fifth Annual NIS Partnership Conference in Atlanta, GA.
• The US Partnership Coordinator received an honorary degree as part of the centennial celebration at SPMU.

• In July and August 1999, two US physicians conducted an assessment of the current primary care program at First Medical University in St. Petersburg. The physicians were a family practice physician and the Executive Associate Dean and a professor of the Department of Family Medicine at Mercer University School of Medicine in Macon, Georgia.
• Four health professionals from St. Petersburg traveled to Atlanta in 1999 for a clinical training; the primary focus of the training was family medicine/general practice. The training was conducted at the Mercer University School of Medicine. The delegation of four included the chief nurse, director and deputy director of Medical Center "Delor," and the Director of the General Practice Department at SPMU.
  

Maternal and Child Health

• As a result of partnership activities, SPMU has received several major donations of medical equipment for use in minimally invasive surgery. The partners have conducted extensive training on these surgical techniques and the NIS partners are now conducting a large volume of minimally invasive surgeries (3,500 in 1998), leading to decreased inpatient lengths of stay, lower infection rates, and improved mortality rates.
• As early in the partnership as 1995, over 1000 laparoscopic procedures, including 60 gynecological procedures, had been performed at Pavlov. In 1998, 700 laparoscopic procedures were performed.
• The St. Petersburg partners have organized a same-day surgery unit.

Ophthalmology

• The partners procured equipment, translated teaching aids and begun successfully to conduct the following procedures: cataract phaco-emulsification, at either the City Multispecialty Hospital No.2 or SPMU; laser therapy for Diabetic Retinopathy, at the Laser Therapy Department of the City Multispecialty Hospital No.2; and vitreo-retinal surgery.

Urology and Endoscopy

• The partners have developed and implemented sterile surgical protocols in the area of urology and endoscopy, leading to reduced rates of infection.
• The Partners conducted training, procured equipment, and conducted kidney operations through transcutaneous access and endosurgery.
• The partners held a two-week educational and training program in Atlanta exposing surgeons from SPMU to radical prostatectomy surgery and treatment procedures for male infertility at both Georgia Baptist and Southeast Fertility Institute. As part of the education exchange, one urologist from St. Petersburg was invited to present a paper on Bilharzia of the urinary tract at Grand Rounds at Emory University.

Nursing Education

• The partners established a Nursing Resource Center (NRC) at the College of Nursing. The center provides nursing faculty students and practitioners with alternative forms of learning that enhance traditional nursing instruction.
• The partners developed a new curriculum for the College of Nursing at SPMU to enhance the clinical knowledge base; the curriculum includes practicums. The new curriculum emphasizes clinical, psychological and pathophysiological skills, as well as English language training. Following successful completion of the courses, graduates serve as head nurses and participate in post-graduate education programs for nurse managers in St. Petersburg.
• To supplement efforts to further nursing education, Georgia Baptist obtained funding from Emory University and the local education community to support educational exchanges for nursing students.

Radiology

• The partners successfully installed the Winrad Teleradiology System and are able to consult over the Internet on an ongoing basis leading to better patient outcomes.

Information Technology

• The partners at SPMU introduced a computer system for patient registration in the emergency room at SPMU.
• The NIS partners installed a patient tracking system on the floors and throughout the institution.
• The partners installed electronic mail in the University. Administrative services have begun to communicate orders via e-mail.
• The secretariat of Russia's National Committee on Information Technologies in Health Care is located at SPMU. This Committee is Russia's official representative to the European Union Committee for Medical Informatics. Committee activities are being performed with the use of modern communication means and INTERNET technologies made available through the partnership.

Family Medicine

• Two experienced US physicians conducted an assessment of the primary care program at First Medical University in St. Petersburg.
• A training on family medicine/general practice was conducted at Mercer University School of Medicine.