The Sustaining Technical and Analytic Resources (STAR) project has received funding from USAID to implement several COVID-19-related activities focused on improving critical care, especially related to patient oxygen supply and ecosystems, in Low- and Middle-Income Countries (LMIC). STAR has engaged our sub-partner, the University of California, San Francisco (UCSF), and their strong relationship with the World Federation of Societies of Anesthesiologists (WFSA), to access technical experts who can provide advice, create tools for assessment, knowledge sharing, and education, and to implement technical assistance in these important aspects of countries’ responses to the COVID-19 pandemic.
Through UCSF-WFSA, we are developing critical care communication tools and an education portal to be utilized by WFSA and in country implementing partners to support local critical care teams responding to the pandemic.
The STAR/UCSF-WFSA team are implementing the following activities in close collaboration with the USAID Sustained Crisis Response Team (SCRT), as well as the teams from other USAID-funded mechanisms, including Reaching Impact, Saturation, and Epidemic Control (RISE), Meeting Targets and Maintaining Epidemic Control (EpiC) project, and other partners.
TECHNICAL ADVISORY GROUP (TAG)
The STAR project is meeting USAID’s has a pressing need for expert technical assistance related to critical care for COVID-19 by accessing technical resources from UCSF’s Anesthesia Division of Global Health Equity (ADGHE), which includes Critical Care and Global Health experts. We have created a subject matter-specific technical advisory group (TAG) to provide immediate expert assistance to USAID on COVID-19 critical care and anesthesia, relevant to resource variable settings. This is being done in collaboration with the WFSA to leverage an existing global network of knowledge on local needs and context specific expertise. The TAG collaborates with implementing partners working to help locate or create data-driven educational tools and clinical care protocols. The TAG fields requests and technical support needs from USAID and implementing partners to STAR/USCF-WFSA subject matter experts when requested.
CRITICAL CARE FACILITY-LEVEL ASSESSMENT SURVEY
The STAR/UCSF-WFSA team developed a survey tool to assess facility level capacity to care for critically ill patients requiring mechanical ventilation. After rapid implementation of the tool by implementing partners (RISE, EpiC, and others), the STAR/UCSF-WFSA team is managing incoming data via Qualtrics and Tableau, providing exportable country level datasets for implementing partners, and creating data reporting (standard data tables and scoring) templates and data dashboard to facilitate data analysis by implementing partners and country partners.
CRITICAL CARE EDUCATION AND ONLINE PORTAL
In partnership with U.S. academic institutions and the WFSA, the STAR/UCSF-WFSA team is planning and beginning to build content and novel dissemination platforms for delivery of a universal anesthesia and critical care curriculum, relevant to resource-variable settings. Due to the urgent need for critical care content, we are focusing primarily on curating existing context-specific modules and courses relevant to COVID critical care in LMICs with an emphasis on respiratory care. We are utilizing the TAG and the WFSA networks to peer review content. Content selection is also based on regular communication with implementing partners to gather feedback on local educational needs, and where possible, includes adapted/translated tools that are created by or are in use by in-country TA partners in order to address country needs and context. The STAR/UCSF-WFSA team will also create select content to fill gaps as relates to the above curriculum.
The content is openly accessible via Open Critical Care, a new online portal, that allows users to access content directly from the web using desktop or mobile devices. For a select number of settings where Internet is not reliable, we will pilot access to content through wireless access point technology.
REMOTE TECHNICAL ASSISTANCE
Facilitating needs assessment and disseminating educational material is only one part of the solution. Providers invariably will require more personalized and directed answers to specific questions. Experts with the ability to answer these questions may be few in the target countries and may be geographically distant from the providers in need. STAR/UCSF-WFSA is establishing a multilayered approach to answering technical ventilator questions and common questions related to COVID. This will incorporate an online directory of common questions and an automated, responsive answering service for mobile use. The structure of technical assistance may differ by country with additional features and support, depending on whether or not an in-country TA partner is present; in the cases where in-country TA partners are present, the technical assistance will be provided to the in-country partner by the TA partner with virtual support from STAR/UCSF as appropriate. This is to ensure that all guidance and responses to questions from host country staff and facilities are unified and avoid confusion or divergent guidance.
For more information about this work, please contact:
Dr. Michael Lipnick
Director, UCSF Anesthesia Division of Global Health Equity
Dr. David Hausner
Sustaining Technical and Analytic Resources (STAR)