Duncan Smith-Rohrberg Maru

Duncan Smith-Rohrberg Maru started a discussion "Mortality Review Programs in Resource-Poor Areas" in the Adherence & Retention community.

Our organization, Nyaya Health, has recently started a mortality review program in which we review all deaths that occur at our hospital in rural Nepal and identifying systems-level changes to prevent future deaths. See our recent blog post on the subject: http://blog.nyayahealth.org/2009/10/29/mortalityreview/ By assessing the root causes of deaths, we hope to assess effectiveness, identify programmatic weaknesses, and make tangible improvements to clinical operations. We would appreciate any feedback on our approach, as well as ...

Duncan Smith-Rohrberg Maru replied to "Mortality Review Programs in Resource-Poor Areas" in the Adherence & Retention community.

Hi Moses, Thank you for your comments. The program is part of a general vision of creating a more responsive health system. The idea is that by reflecting on deaths-- in some ways the ultimate arbiter of epidemiological and clinical truth-- we can improve how we operate as a team. As with any well-functioning M&M review, the aim is not to assign blame but rather to identify systems-levels issues. For specifics of how this actually ...

Duncan Smith-Rohrberg Maru replied to "Creating an intranet for PIH-Rwanda" in the Health IT community.

It sounds as if your team requires two big functionalities: 1) better email communication; 2) file-sharing. Both of these should be very easy-to-use and accessible over low BW. They should be accessible offline given unstable internet connections. Regarding the ability of staff to use them, admittedly no software exists that can overcome language and computer literacy. That can only be accomplished through training. The only suggestion would be to pick one or two approaches/strategies and ...

Duncan Smith-Rohrberg Maru replied to "Surgical Implementation Protocol from BMJ Open" in the Global Surgery & Anesthesia community.

Thank you all for your comments. I do think we need to fully revamp our core process and outcomes measures. over the course of the month, we aim to get those revised and back for public scrutiny. Also, in discussing the project with Gita Mody (PGY5 resident at BWH), she made two very important insights: 1) the importance of conceptualizing clinical teams (e.g., OR or trauma) at the heart of implementation and quality problems; 2) ...

Duncan Smith-Rohrberg Maru started a discussion "Financial Transparency for Global Health Delivery" in the Health IT community.

Our organization (nyayahealth.org) is experimenting with a public-access wiki to provide our line-by-line budget that is accessible to all. The public can view both aggregate and line-by-line data updated monthly on our wiki. We do this as follows. Our Nepal team exports data from our accounting database (Quickbooks) and sends it over to our data management volunteers in the US. The US team then posts them into templated online spreadsheets. These go onto our wiki: ...