Pronto International

PRONTO INTERNATIONAL AIMS TO OPTIMIZE CARE DURING BIRTH. WE DEVELOP AND IMPLEMENT INNOVATIVE TRAINING STRATEGIES FOR HEALTH CARE PROVIDERS THAT ACT AS A CATALYST FOR INDIVIDUAL, TEAM, AND SYSTEM CHANGE.

PRONTO INTERNATIONAL DESIGNS AND CONDUCTS SIMULATION-BASED TRAINING FOR HEALTHCARE PROVIDER TEAMS USING AN INNOVATIVE, EVIDENCE-BASED APPROACH TO HELP LEARNERS MOVE FROM KNOWLEDGE TO PRACTICE IN THE MANAGEMENT OF MATERNAL AND NEWBORN EMERGENCIES DURING THE INTRAPARTUM PERIOD. IN ADDITION TO STRENGTHENING INDIVIDUAL PROVIDER SKILLS AND KNOWLEDGE, THE TRAINING STRENGTHENS TEAMWORK AND COMMUNICATION, INTER-PROFESSIONAL COLLABORATION, AND PERSON-CENTERED MATERNAL CARE (PCMC). PRONTO'S UNIQUE SIMULATION-BASED TRAININGS ALLOW HEALTHCARE PROVIDER TEAMS TO PRACTICE SKILLS IN SIMULATED HIGH-STRESS ENVIRONMENTS, ENSURING THAT THEY ARE PREPARED TO RESPOND EFFICIENTLY AND EFFECTIVELY DURING AN EMERGENCY. 2022 WAS ANOTHER YEAR OF BUILDING OPPORTUNITY OUT OF THE CHANGES BROUGHT ON BY COVID-19. PRONTO CONTINUED TO INNOVATE AND CREATE NEW AND ADAPTED PRODUCTS AND SERVICES THAT WOULD ALLOW US TO FULFILL OUR MISSION TO SUPPORT CLINICAL PROVIDERS WHO CARE FOR THE MOST VULNERABLE MOTHERS AND BABIES. WE WERE PROUD TO BE PART OF THE INITIATIVES BELOW. LINQED: LEADING INNOVATION IN QUALITY-OF-CARE EDUCATION PARTNERSHIP, BIHAR AND UP, INDIA. PRONTO BEGAN TO WRAP UP OUR MULTI-YEAR PARTNERSHIP WITH LINQED (UNIVERSITY OF CALIFORNIA AT SAN FRANCISCO AND UNIVERSITY OF UTAH) ON A GATES FOUNDATION FUNDED PROJECT TO BUILD THE CAPACITIES OF LOCAL HEALTH CARE PROVIDERS IN THE TWO LARGEST STATES OF UTTAR PRADESH AND BIHAR IN INDIA. IN RESPONSE TO A REQUEST FROM THE GOVERNMENT OF BIHAR, WE CONDUCTED RESPECTFUL MATERNITY CARE (RMC) TRAINING FOR THE HEALTHCARE PROVIDERS AND SUPPORT STAFF IN ALL 36 DISTRICT HOSPITALS AND 2 SUB-DISTRICT HOSPITALS IN THE STATE OF BIHAR. WE ALSO PARTNERED WITH AIIMS, DELHI AND AOGD (ASSOCIATION OF OBSTETRICIANS AND GYNECOLOGISTS OF DELHI) TO OFFER A TRAINING OF THE TRAINERS (TOT) FOR RESPECTFUL MATERNITY CARE FOR PROFESSORS FROM 12 MEDICAL COLLEGES IN DELHI. IN RESPONSE TO GOVERNMENT OF INDIA'S LAUNCH OF A NEW CADRE OF NURSE PRACTITIONER MIDWIFE IN 2021, WE DEVELOPED AND IMPLEMENTED A MIDWIFERY EDUCATOR TRAINING PROGRAM IN COLLABORATION WITH THE FERNANDEZ FOUNDATION AND THE GOVERNMENT OF TELANGANA. WE ALSO CONDUCTED AN RMC TOT FOR THE DOCTORS AND STAFF OF THE UP TECHNICAL SUPPORT UNIT (UPTSU) IN LUCKNOW. THIS WAS FOLLOWED BY A SIMULATION FACILITATION TRAINING TO STRENGTHEN THE FRU TEAM WITHIN UPTSU. AS PART OF OUR SUSTAINABILITY EFFORTS, WE PARTNERED WITH AASTRIKA FOUNDATION TO HOST SEVERAL OF OUR VIDEOS AND LEARNING MODULES ON THEIR LEARNING PLATFORM. THIS CONTENT IS FREELY AVAILABLE TO THE HEALTHCARE PROFESSIONALS. WE ALSO INCREASED OUR SOCIAL MEDIA PRESENCE ON VARIOUS PLATFORMS TO INCREASE PUBLIC AWARENESS OF OUR PROGRAMS AND OUR VISION. WE PRESENTED OUR WORK AT THE HSR CONFERENCE IN COLOMBIA IN OCTOBER. PRONTO CONTINUED WORKING ON THE FOURTH YEAR OF THE USAID FUNDED ALACANAR PROJECT BEING IMPLEMENTED IN MOZAMBIQUE AND LED BY FHI360. THE OVERARCHING OBJECTIVE FOR PRONTO IN PY4 OF THE ALACANAR PROJECT WAS TO CONTINUE TO UPGRADE AND IMPROVE THE SIMULATION AND TEAM TRAINING MENTOR CADRE'S SKILLS AS SIMULATION FACILITATORS. EFFORTS CONTINUED TOWARD MAKING THE SIMULATION AND TEAM TRAINING PROGRAM SUSTAINABLE LOCALLY FOR THE MODEL PROVINCE OF NAMPULA. IN PY4 PRONTO: MOVED THE FIRST MENTOR CADRE OF 15 NAMPULA-BASED MENTORS TO MASTER TRAINERS THROUGH, 1 COACHING SESSION AND TWO IN-PERSON TRAINING EVENTS, THE SECOND OF WHICH WAS THE NEW MASTER TRAINER MENTOR CADRE THAT RAN THE SFT FOR 20 NEW MENTORS FROM NAMPULA. AFTER THE MASTER TRAINING IN JUNE, 2022 WE CELEBRATED THE GRADUATION OF 15 MENTORS THAT HAVE ACHIEVED MASTER FACILITATOR STATUS; RESUPPLIED NAMPULA-BASED MASTER TRAINERS (15) WITH ADDITIONAL SIMULATION SUPPLIES; PROVIDED 32 FULL MENTOR KITS - 20 FOR NEW MENTORS IN NAMPULA; PROVIDED 12 FULL MENTOR KITS FOR NEW MENTORS IN ZAMBEZIA; CREATED A MANUAL OF MATERIALS AND SUPPLIES TO GUIDE LOCAL STAKEHOLDERS IN LOCALLY SOURCING SIMULATION AND TEAM TRAINING SUPPLIES IN THE FUTURE; WORKED COLLABORATIVELY TO PREPARE A PROCESS EVALUATION TO COMPARE EVIDENCE BASED BEHAVIOR IN SIMULATION OF PROVIDERS WHO HAVE BEEN EXPOSED TO SIMULATION WITH PROVIDERS WHO HAVE HAD LITTLE TO NO EXPOSURE TO SIMULATION. PRONTO CONTINUED WORKING ON THE THIRD YEAR OF THE USAID FUNDED KULAWA PROJECT BEING IMPLEMENTED IN NIGER AND LED BY SAVE THE CHILDREN. PRONTO'S ACHIEVEMENTS THIS QUARTER INCLUDED: FINALIZING SUPPLY PROCUREMENT AND PACKING OF THE 51 MENTOR KITS IN THE UNITED STATES, FINALIZING TRANSLATION OF PRONTO'S CURRICULUM INTO FRENCH FOR THE FIRST SET OF TRAININGS, ALIGNING AND REFINING PRONTO'S MENTORING MODEL TO MATCH THE NIGERIEN CONTEXT, CREATING THE PRONTO IMPLEMENTATION PLAN FOR MENTORSHIP, PREPARATION OF FRENCH-SPEAKING PRONTO TRAINERS FOR WORK IN NIGER, CREATION OF TRAINING AGENDAS, AND PLANNING FOR THE FIRST SET OF TRAININGS, TO BE HELD IN THE SECOND QUARTER OF PROJECT YEAR 2. IN COLLABORATION WITH IN-COUNTRY PARTNERS, PRONTO ADAPTED THE TRAINING AGENDAS TO THE USAID KULAWA PROJECT AND CREATED STEP-BY-STEP GUIDES FOR EACH TRAINING, INCLUDING: THE SIMULATION FACILITATOR TRAINING, THE PEER FACILITATOR TRAINING, THE SIMULATION ASSISTANT TRAINING, AND THE MENTOR VIDEO TRAINING. TO CREATE LOCAL CAPACITY, PRONTO VIRTUALLY TRAINED KULAWA'S 3 TECHNICAL COORDINATORS AND 1 MNH SPECIALIST TO BE 'PRONTO PEER FACILITATORS' BY ENGAGING IN VIDEO MODULES ON PRONTO'S METHODOLOGY, SUPPLIES, AND FACILITATION TECHNIQUES AND TAKE QUIZZES FOLLOWING EACH VIDEO. AN IN-PERSON "PEER FACILITATOR TRAINING" WAS HELD EARLY IN QUARTER TWO TO TRAIN KULAWA'S 6 TECHNICAL COORDINATORS AND 1 MNH SPECIALIST IN PRONTO'S METHODOLOGY, SIMULATION SUPPLIES, AND FACILITATION AND DEBRIEFING APPROACH. THIS TRAINING WAS INTENDED TO PREPARE THE COHORT OF PEER FACILITATORS TO LEAD THE MENTOR VIDEO TRAINING, ASSIST PRONTO'S MASTER TRAINERS AT THE SIMULATION FACILITATOR TRAINING IN MARCH 2022, AND PROVIDE SUPPORTIVE SUPERVISION TO MENTORS ONCE THEY WERE ACTIVE IN THE FIELD. IN MARCH 2022, 59 PROJECT MENTORS AND REPRESENTATIVES FROM THE MINISTRY OF HEALTH (MOH) AND DRSP CAME TOGETHER FOR THE FIVE-DAY SIMULATION FACILITATOR TRAINING. THE OBJECTIVE OF THIS TRAINING WAS TO TRANSFER FACILITATION AND DEBRIEFING SKILLS TO LOCAL FACILITATORS, SUCH THAT THEY CAN IMPLEMENT PRONTO SIMULATION AND TEAM-TRAINING ACTIVITIES IN NIGERIEN FACILITIES INDEPENDENTLY. EACH PARTICIPANT'S PERFORMANCE AT THE TRAINING WAS EVALUATED BY PRONTO'S MASTER TRAINERS AND THOSE EVALUATIONS HELPED THE KULAWA PROJECT IN THE HIRING PROCESS OF THE FULL-TIME MENTORS. THE PEER FACILITATORS, TRAINED IN JANUARY 2022, LED REGIONAL MENTOR VIDEO TRAININGS, A TWO-DAY TRAINING THAT USED PRONTO'S VIDEO MODULES TO INTRODUCE CORE PRONTO SIMULATION AND TEAM-TRAINING CONCEPTS TO THE FUTURE PROJECT MENTORS. SOME OF THE CONCEPTS COVERED INCLUDED: INTRODUCTION TO SIMULATION, DRESSING THE PATIENT ACTRESS, MAKING BLOOD, FACILITATING SIMULATION, PREPARING TO DEBRIEF, AND MORE. IN THE UNITED STATES, PRONTO CONTINUED TO PILOT OUR NEW CURRICULUM, PRONTOSTAT, DESIGNED TO BE A COMPREHENSIVE, MULTI-MODULAR, SCENARIO-BASED SIMULATION TRAINING CURRICULUM WITH ACCOMPANYING SIMULATION MATERIALS. AFTER PILOTING PRONTOSTAT IN MOAB, UTAH IN 2020-21, THE CONSORTIUM, WITH SEED FUNDING FROM JOHNSON & JOHNSON, SOUGHT TO DETERMINE THE FEASIBILITY AND ACCEPTABILITY OF THIS LOW-COST TRAINING SOLUTION FOR RURAL PROVIDERS IN OTHER LOCATIONS, AND HOW TO HAVE A LOWER IMPACT ON THE HEALTH SYSTEM AND HEALTHCARE PROVIDERS TIME, AS WELL AS HOW TO TRANSITION THE FACILITATION OF THIS TRAINING CONCEPT OVER TO LOCAL PROVIDERS. TO DO SO, THE CONSORTIUM SCALED DOWN ITS TRAINING TEAM TO BETTER REFLECT THE NUMBER OF TRAINERS AVAILABLE IN RURAL SETTINGS. LOCAL EMS AND ED CHAMPIONS WERE INTEGRATED INTO THIS PILOT AND WERE TRAINED AS 'PEER FACILITATORS' WHO ARE RESPONSIBLE FOR TAKING A LEADERSHIP ROLE IN THE INTERVENTION BY: 1) LEARNING PRONTO'S SIMULATION AND TEAM-TRAINING METHODOLOGY, 2) ASSISTING PRONTO TRAINERS IN FACILITATING TWO UNI-PROFESSIONAL PRONTOSTAT TRAININGS IN JULY 2022, 3) CONTINUING TO EXPOSE EMS AND ED COHORTS TO SIMULATION AFTER THE JULY 2022 TRAINING, AND 4) ASSISTING PRONTO TRAINERS IN FACILITATING THE INTERPROFESSIONAL PRONTOSTAT TRAINING LATER IN 2022. THIS ADAPTED APPROACH TO THE SECOND SITE WILL ALLOW THE CONSORTIUM TO EXPLORE THE FEASIBILITY AND ACCEPTABILITY OF THIS SUSTAINABLE, SCALABLE MODEL OF TRAINING. WITH THAT IN MIND, PRONTOSTAT PILOTED A PEER FACILITATOR TRAINING FOR PROVIDERS IN MARTINSVILLE, INDIANA AT MORGAN COUNTY EMS AND INDIANA UNIVERSITY - MORGAN, EMERGENCY DEPARTMENT. THESE PROVIDERS WERE SELECTED BY THOSE IN LEADERSHIP POSITIONS AS POTENTIAL "CHAMPIONS" TO CONTINUE FACILITATING AND LEADING THE SIMULATION TRAINING ACTIVITIES WITH THEIR OWN TEAMS, AFTER THE TRAINING WAS OVER. EXPANDING OUR U.S.-BASED WORK, IN 2022 PRONTO BEGAN BUILDING A PARTNERSHIP WITH SMOOTH TRANSITIONS, AN INITIATIVE IN WASHINGTON STATE HOUSED IN THE FOUNDATION FOR HEALTHCARE QUALITY. SMOOTH TRANSITIONS FOCUSES ON COMMUNITY MIDWIVES, HOSPITAL PROVIDERS AND STAFF, AND EMS PERSONNEL

PRONTO INTERNATIONAL DESIGNS AND CONDUCTS SIMULATION-BASED TRAINING FOR HEALTHCARE PROVIDER TEAMS USING AN INNOVATIVE, EVIDENCE-BASED APPROACH TO HELP LEARNERS MOVE FROM KNOWLEDGE TO PRACTICE IN THE MANAGEMENT OF MATERNAL AND NEWBORN EMERGENCIES DURING THE INTRAPARTUM PERIOD. IN ADDITION TO STRENGTHENING INDIVIDUAL PROVIDER SKILLS AND KNOWLEDGE, THE TRAINING STRENGTHENS TEAMWORK AND COMMUNICATION, INTER-PROFESSIONAL COLLABORATION, AND PERSON-CENTERED MATERNAL CARE (PCMC). PRONTO'S UNIQUE SIMULATION-BASED TRAININGS ALLOW HEALTHCARE PROVIDER TEAMS TO PRACTICE SKILLS IN SIMULATED HIGH-STRESS ENVIRONMENTS, ENSURING THAT THEY ARE PREPARED TO RESPOND EFFICIENTLY AND EFFECTIVELY DURING AN EMERGENCY. 2023 WAS ANOTHER YEAR OF BUILDING OPPORTUNITY OUT OF THE CHANGES BROUGHT ON BY COVID-19. PRONTO CONTINUED TO INNOVATE AND CREATE NEW AND ADAPTED PRODUCTS AND SERVICES THAT WOULD ALLOW US TO FULFILL OUR MISSION TO SUPPORT CLINICAL PROVIDERS WHO CARE FOR THE MOST VULNERABLE MOTHERS AND BABIES. WE WERE PROUD TO BE PART OF THE INITIATIVES BELOW. PRONTO CONTINUED WORKING ON THE FOURTH YEAR OF THE USAID-FUNDED ALCANAR PROJECT BEING IMPLEMENTED IN NAMPULA AND ZAMBEZIA PROVINCES IN MOZAMBIQUE AND LED BY FHI360. THE OVERARCHING OBJECTIVES FOR PRONTO IN PY5 OF THE ALCANAR PROJECT WERE TO CONTINUE TO UPGRADE AND IMPROVE THE SIMULATION AND TEAM TRAINING MENTOR CADRE'S SKILLS AS SIMULATION FACILITATORS, BUILD SUPPORT FOR LOCALIZED SIMULATION SUPPLY PROCUREMENT, AND CONTINUE THE PROCESS OF CONDUCTING A SMALL RESEARCH PROJECT. EFFORTS CONTINUED TOWARD MAKING THE SIMULATION AND TEAM TRAINING PROGRAM SUSTAINABLE LOCALLY FOR THE MODEL PROVINCE OF NAMPULA. IN PY5 PRONTO ACCOMPLISHMENTS WERE: A TWO-WEEKS OF TRAINING WHERE THE NAMPULA-BASED ADVANCED SIMULATION FACILITATORS UNDERWENT ONE WEEK OF MASTER TRAINER TRAINING AND THEN WENT ON TO IMMEDIATELY CONDUCT THEIR FIRST SIMULATION FACILITATOR TRAINING ON THEIR OWN, WITH PRONTO SUPERVISION FOLLOWED BY REMOTE COACHING SUPPORT. NEW SIMULATION KITS WERE SUCCESSFULLY SHIPPED TO ZAMBEZIA FOR 20 NEW MENTORS TO RECEIVE TRAINING AND BEGIN THE PROCESS OF ROLLING OUT SIMULATION THERE. PRONTO CREATED A DETAILED WORKBOOK THAT CAN BE USED FOR PROCUREMENT OF SUPPLIES FOR SIMULATION AND TEAM TRAINING USED FOR THE PRONTO MODEL. BEGIN THE PROCESS OF SETTING UP A COMPARISON STUDY OF PROVIDERS WHO HAVE PARTICIPATED IN A SIGNIFICANT NUMBER OF SIMULATION SESSIONS WITH THOSE WHO HAVE HAD NO SESSIONS. THE COMPARISON IS DESIGNED TO COMPARE EVIDENCE-BASED CLINICAL, TEAMWORK AND RESPECTFUL CARE PRACTICES IN SIMULATION. PRONTO ENDED ITS WORK DURING THE THIRD YEAR OF THE USAID-FUNDED KULAWA PROJECT BEING IMPLEMENTED IN NIGER AND LED BY SAVE THE CHILDREN. PRONTO'S INVOLVEMENT WAS CUT SHORT DUE TO INSTABILITY OF TRAINING TEAM TO TRAVEL TO RUN SIMULATION THUS REDUCING THE PLANNED OUTCOMES IN TERMS OF NUMBER OF FACILITIES REACHED, AND THE ATTEMPTED COUP. PRONTO CONTINUES TO DEVELOP OPPORTUNITIES FOR SUSTAINABLE IMPLEMENTATION OF SIMULATION AND TEAM TRAINING IN MIDWIFERY AND IN-SERVICE SETTINGS IN VARIOUS STATES IN INDIA. PRONTO'S ACHIEVEMENTS THIS YEAR INCLUDED: IN THE UNITED STATES, PRONTO CONTINUED TO PILOT OUR NEW CURRICULUM, PRONTOSTAT, DESIGNED TO BE A COMPREHENSIVE, MULTI-MODULAR, SCENARIO-BASED SIMULATION TRAINING CURRICULUM WITH ACCOMPANYING SIMULATION MATERIALS. WE WORKED WITH DARTMOUTH HITCHCOCK HOSPITAL AND THE LOCAL EMS SERVICE (CALLED STONE) TO ADAPT A TRAINING CURRICULUM INTO SIMULATION SESSION BLOCKS THAT WOULD BETTER FIT EMS PERSONNEL AVAILABILITY TO TRAIN. PRONTO AND STONE WILL CONDUCT A PILOT TRAINING OF THIS CURRICULUM IN PRONTO'S NEXT FISCAL YEAR. EXPANDING OUR U.S.-BASED WORK, IN THIS PAST FISCAL YEAR PRONTO CONDUCTED TWO PILOT TRAININGS IN LACEY, WA AND BELLINGHAM, WA PARTNERSHIP WITH SMOOTH TRANSITIONS, AN INITIATIVE IN WASHINGTON STATE HOUSED IN THE FOUNDATION FOR HEALTHCARE QUALITY. SMOOTH TRANSITIONS FOCUSES ON COMMUNITY MIDWIVES, HOSPITAL PROVIDERS, AND STAFF, AND EMS PERSONNEL TO BUILD A COLLABORATIVE MODEL OF CARE THAT PUTS BIRTHING FAMILIES AT THE CENTER.

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