Project Title

Building Capacity in Infection Control and Outbreak Containment to Novel Pathogens in Healthcare Settings 

Project Year

2016   

Project Number

HWG 03 2016A 

Project Session

Session 2   

Project Type

Standard 

Project Status

Project in Implementation   
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Project No.

HWG 03 2016A 

Project Title

Building Capacity in Infection Control and Outbreak Containment to Novel Pathogens in Healthcare Settings 

Project Status

Project in Implementation 

Publication (if any)

 

Fund Account

APEC Support Fund 

Sub-fund

ASF: Human Security 

Project Year

2016 

Project Session

Session 2 

APEC Funding

101,236 

Co-funding Amount

45,200 

Total Project Value

146,436 

Sponsoring Forum

Health Working Group (HWG) 

Topics

Health 

Committee

SOM Steering Committee on Economic and Technical Cooperation (SCE) 

Other Fora Involved

Emergency Preparedness Working Group (EPWG) 

Other Non-APEC Stakeholders Involved

 

Proposing Economy(ies)

Singapore 

Co-Sponsoring Economies

Australia; China; Malaysia; Peru; Philippines; Chinese Taipei; United States; Viet Nam 

Expected Start Date

01/03/2017 

Expected Completion Date

31/12/2017 

Project Proponent Name 1

Dr Angela Chow 

Job Title 1

Head and Senior Consultant 

Organization 1

Department of Clinical Epidemiology, Institute of Infectious Diseases and Epidemiology, Communicable Disease Centre, Tan Tock Seng Hospital 

Postal Address 1

Moulmein Road, Singapore 308433 

Telephone 1

65-63577477 

Fax 1

Not Applicable 

Email 1

Angela_Chow@ttsh.com.sg 

Project Proponent Name 2

Not Applicable 

Job Title 2

Not Applicable 

Organization 2

Not Applicable 

Postal Address 2

Not Applicable 

Telephone 2

Not Applicable 

Fax 2

Not Applicable 

Email 2

Not Applicable 

Declaration

Dr Angela Chow 

Project Summary

Healthcare associated infections (HCAIs) represent the most frequent adverse problem in healthcare delivery worldwide that affects both patients and healthcare workers. While HCAIs usually receive attention in times of epidemics, they are an ongoing problem during peacetime as well, plaguing both developed and less-developed economies alike.

This training proposal aims to build capacity in frontline healthcare workers from developing APEC economies. More specifically, it plans to impart infection prevention and control, and outbreak management skills and knowledge. These would not only empower healthcare workers to effectively carry out their duties, but also better protect them and patients against HCAIs.

Participants will undergo experiential learning through re-enactment of real-life scenarios using simulation technology. They will also learn from transnational sharing, and Singapore’s National Disease Outbreak Response Centre’s own experience in containing the SARS and H1N1 influenza pandemics, as well as in preparing for emerging HCAI threats like Ebola and MERS Co-V.

Relevance

Relevance – APEC: Healthcare associated infections (HCAIs)[1] represent the most frequent healthcare-associated adverse events in healthcare delivery that affects both patients and healthcare workers. According to the WHO Clean Care is Safer Care team, hundreds of millions of patients are affected by HACIs worldwide each year, not only incurring significant financial losses to health systems, but also causing unnecessary deaths.

HCAIs usually only receive public attention in times of epidemics. In the early days of the Ebola outbreak for instance, it was reported that an unprecedented number of healthcare workers were infected due to poor infection control measures. Alas, this belies the fact that HCAIs is actually an ongoing problem during peacetime as well, plaguing both developed and less-developed economies alike. This is attributed to factors like prolonged use of invasive devices and the conduct of high-risk procedures, which are present regardless of resources available. Further, HCAIs affect less developed economies to a larger extent, as other factors such as poor hygiene and waste disposal, lack of basic infection prevention and control knowledge and implementation, and unsafe procedures, are more specific to resource-limited settings. Sadly, fatalities caused by HCAIs are easily preventable.

With the continued occurrence of other infectious diseases that can be transmitted nosocomially like MERS Co-V, Avian Influenza, and Tuberculosis, it is crucial that we equip frontline healthcare workers with the knowledge and skills in infection prevention and control,2 outbreak management, and healthcare epidemiology.3 The aim is to empower them to carry out their duties effectively, but also to better protect themselves and patients against HCAIs. This envisages reduced incidence of HCAIs, and in turn, lower mortality and financial losses to health systems in the region. Moreover, sustained benefits do not only accrue to the healthcare workers and wider health populations of the participating economies, but also to those of non-participating APEC economies. This is because infectious threats are not confined within domestic boundaries, and novel pathogens can emerge and spread rapidly throughout the region if not contained at source.

In view of the above context, the Institute of Infectious Diseases and Epidemiology in Singapore’s Tan Tock Seng Hospital proposes a 5-day workshop to build up the capacity of frontline healthcare workers from developing APEC economies. The workshop will be conducted by a multidisciplinary team of experts comprising infectious disease physicians, public health physicians, infection prevention and control nurses, epidemiologists, and biostatisticians among others. Participants will undergo experiential learning through the re-enactment of real-life scenarios using simulation technology. They will also learn about the team’s experience in the management of the SARS epidemic in 2003 and A/H1N1 influenza pandemic in 2009, as well as ongoing preparations for more recent emerging infectious diseases like Ebola and MERS Co-V.

Relevance – Rank: The proposed project is directly linked to Ranks 1 and 2 of the 2016 APEC Funding Criteria. 

Rank 1: The proposed project demonstrates a direct link to promoting regional economic integration via free and open trade and investment, by supporting human capital development through cooperation in education and skills development, as well as facilitating infectious disease outbreak management. 

Rank 2: The proposed project promotes innovative growth by harnessing science and technology and ICT approaches. This is done through the use of Simulation Technology in the training of healthcare workers in the management of Ebola and other highly infectious patients. In addition, the project promotes secure growth by strengthening individual and regional health systems in dealing with disease outbreaks through skills and knowledge development, and the establishment of a regional network for rapid outbreak containment. In these regards, the project supports the APEC Strategy for Strengthening Quality Growth.


[1] HCAIs are otherwise known as “hospital” or “nosocomial” infections. They affect patients in a healthcare facility but were not present or incubating at the time of admission. They also include infections acquired by patients in the facility but only appearing after discharge, as well as occupational infections among healthcare workers.

2 Infection prevention and control involves the use of appropriate and adequate personal protective equipment such as masks and gowns and the adoption of good disinfection practices including hand hygiene. Developing economies often face lack of financial support and inadequate numbers of healthcare personnel trained in infection prevention and control.

3 Healthcare epidemiology is the field that i) measures the burden of healthcare associated infections (HCAI) such as NDM-1, and includes novel pathogens such as MERS Co-V and Ebola, ii) identifies and characterizes risk factors for HCAI, and iii) determines ways to mitigate and control these infections. The field involves activities such as disease surveillance, contact tracing, outbreak response, and enhanced understanding of risk factors for acquisition of infections.

Objectives

a) To increase knowledge and skills in the principles and practices of healthcare epidemiology, surveillance, contact tracing, and outbreak management among healthcare workers. 

b) To build capacity in the appropriate application of infection control practices and measures in different situations. 

c)  To build a regional network for rapid outbreak containment in response to novel pathogens.

Alignment

Alignment – APEC: The project supports APEC’s 2016 priorities, namely Advancing Regional Economic Integration and Human Capital Development:

     By facilitating cross-border training, education, and skills development, one of the expected outcomes of the proposed workshop is a pool of skilled frontline healthcare workers involved in the care and management of infectious patients in acute healthcare settings in the region. 

     By adopting the “train-the-trainers” model, the trained healthcare workers would not only be able to help manage future infectious disease outbreaks in their home economies, but also later impart the relevant skills to fellow healthcare professionals back home. Through the workshop, participants’ will set their own training goals and develop economy-specific training programmes adapting from best practices learnt from the workshop that can be translated and implemented in their home economies to prevent HCAIs.  This transference of skills and knowledge across and within borders thus not only facilitates regional economic integration, but also empowers more healthcare workers especially in developing APEC member economies to carry out their duties effectively, and to better protect themselves and patients from HCAIs. One of the significant obstacles to sustainable economic growth faced by APEC economies includes the economic and health burdens brought about by otherwise preventable HCAIs. 

Alignment – Forum: The project is well-aligned with the Healthy Asia Pacific 2020 Roadmap, which was endorsed in August 2015 in Cebu, Philippines. Of note, it advances efforts in the following items: 

·  One of the Roadmap’s four key areas, namely ‘Improving health emergency preparedness, surveillance, response and recovery systems for public health emergencies, including pandemic events and natural disasters.’

·  Complementary action D, ‘Enhance Regional Cooperation on Human Security’, in terms of addressing emerging and reemerging infectious disease outbreaks by equipping frontline healthcare workers with infection prevention and control, as well as outbreak management skills and knowledge.

TILF/ASF Justification

The project will provide training opportunities in infection control and outbreak containment for frontline healthcare workers in APEC developing economies in Singapore’s National Disease Outbreak Response Centre. The proposed workshop will directly engage and train a pool of frontline healthcare workers involved in the care and management of infectious patients in acute healthcare settings in APEC developing economies. Additionally, adopting the “train-the-trainers” model as earlier mentioned, would enable trained healthcare workers to impart the relevant knowledge and skills to other healthcare professionals back home, and in turn enable the ramp-up of capacity building.

Beneficiaries and Outputs

Outputs: The project will design and develop a training curriculum in Infection Control and Outbreak Containment to Novel Pathogens in Healthcare Settings, and conduct a hands-on workshop based on simulation training and experiential learning over the course of one year. A project completion report, including action plans from participants, will be produced. 

Outcomes: The project will lead to an increase in trained healthcare personnel to respond and manage emerging infectious threats in APEC economies. The knowledge and skills of frontline healthcare workers in infection prevention and control will be enhanced, enabling them to better protect themselves, patients and their caregivers from healthcare-associated infections, and from getting infected with emerging infectious diseases such as Ebola from healthcare settings. This project also supports one of the recommendations outlined in the 2013 APEC Policy Toolkit for Building Capacity to Prevent and Control HAIs and that is supporting  capacity building in HAI prevention and control through training, and public-private partnerships. 

Beneficiaries: Targeted beneficiaries include frontline healthcare workers (doctors, nurses, epidemiologists, allied health professionals) from developing economies who work in acute hospitals managing infectious patients. An equal number of male and female participants will be selected. With the proposed “train-the-trainers” model, beneficiaries of the programme would extend to healthcare workers in APEC economies who would be trained by workshop participants.

Dissemination

Twenty-two participants from APEC developing economies will be supported to attend the 5-day hands-on experiential workshop in Singapore. With the “train-the-trainers” model, participants will be given a folder containing the training materials which they can use to train other healthcare professionals in their home economies. Online platforms will be developed by the Institute of Infectious Diseases and Epidemiology in Singapore for sharing of best practices among graduates from the workshops and to sustain a community of practice and regional network. Furthermore, the training materials used at the workshop will be posted to the APEC publications database. We also welcome participants from developed economies who can self-fund to attend the workshop.

Gender

An equal number of male and female participants will be selected for the workshop. The project objectives will empower female healthcare professionals involved in the care and management of infectious patients in acute healthcare settings.

Work Plan

The timeline of the project is as follows:

Activities

Q1 2017

Q2 2017

Q3 2017

Q4 2017

1. Design and develop training

programme and training materials

      X      X

2. Publicise training programme and

shortlist participants

     X      X

3. Conduct training workshop

     X

4. Post-workshop Evaluation & Monitoring

4.1 One, three and six months
4.2 One year project progression

     X

Risks

Due to work exigencies and other unforeseen circumstances, participants might have to pull out of the workshop at the eleventh hour. The organisers of the project will maintain a reserve list of participants, who will be promptly informed to replace the participant(s) who could not attend. 

After workshop completion, some participants may not have the ability to take on the role of a trainer in their home economy.  Depending on the need and the challenges in their respective work areas, participants are encouraged to continue engagements with our trainers in Singapore where guidance on planning, development and implementation can be rendered. In the selection of participants for the workshop, the organisers will work closely with the Ministries/Departments of Health of APEC economies to ensure that the most appropriate candidates are selected for the workshop. After the workshop, the organisers will also continue to keep in touch with participants on their progress and monitor the success of train-the-trainers programmes in the respective APEC economies.

Monitoring and Evaluation

Potential indicators to measure the progress of the project include the number of participants (including a breakdown in the number of men and women, and the number of APEC developing member economies) who attended the workshop. Project impact will be measured by a pre- and post-workshop survey to determine the knowledge and competencies gained, including specific assessment on the impact on women. Additionally, a pre-workshop questionnaire will be implemented to identify and determine baseline infection control and outbreak containment practices in the participants’ home economies, to better tailor the training programme to meet specific needs. 

Participants will be guided to set their own training goals and develop economy-specific training programmes adapting from best practices learnt from the workshop that can be translated and implemented in their home economies to prevent HCAIs. Through online platforms, participants will be engaged at one, three, and six months, and at 1 year post-workshop to share on their progress in implementing their training programmes. 

Participants will also be encouraged to provide specific indicators for monitoring improvements in infection control and outbreak containment capabilities and reduction in HCAIs in their respective healthcare institutions.

Linkages

We plan to engage all Ministries/Departments of Health of APEC economies in nominating eligible participants from their respective healthcare institutions. Further, we have contacts with some of the designated infectious disease hospitals in the region, and can approach them directly for nominations to the workshop. We aim to build on our previous work in regional capacity building, including an Outbreak Management Training programme for a group of Vietnamese health officials (2013) and an Outbreak Investigations and Management Course for an international group of clinical and public health professionals (2014).

The previous workshops however, addressed more specific interest topics and could only be provided on an ad-hoc basis due to the lack of designated funding. This APEC proposal aims to establish a more formal platform for providing comprehensive training in infection prevention and control and outbreak management, and will enable the use of novel simulation technologies for more experiential learning. With a mix of participants from various APEC member economies, participants can learn from a wide range of experiences and best practices, and be better equipped to respond to infectious threats. The proposed workshop will also provide an invaluable platform for networking. Networks and friendships developed would translate into closer collaborations and more coordinated and timely responses to emerging and re-emerging infectious threats in the region.

APEC’s Healthy Asia Pacific 2020 Roadmap sets a useful context and guide for the development and implementation of the proposed workshop. As mentioned earlier, the Roadmap outlines a complementary action (D) of ‘Enhance Regional Cooperation on Human Security’, and seeks to address emerging and reemerging infectious disease outbreaks, and to improve infection prevention and control. This is exactly what the proposed workshop hopes to achieve by equipping frontline healthcare workers with knowledge and skills in infection prevention and control, as well as outbreak management.

Sustainability

By adopting the “train-the-trainers” model, the healthcare workers trained by the project will be able to use the training materials to train other healthcare professionals in their home economies, who will then move on to train other colleagues This encourages a continuous cycle of sharing and learning across and within economies.

A group email will be created for graduates from the programme, which will be used as a platform for continued information exchanges and sharing of experience after the programme. Graduates will also be contacted periodically to check on their progress, and will be kept updated with latest developments in infection prevention and control via the group email, as well as the Institute of Infectious Diseases and Epidemiology Facebook page and the Institute’s Newsletters.

Project Overseers

Dr Angela Chow, Head and Senior Consultant at the Department of Clinical Epidemiology at the Institute of Infectious Diseases and Epidemiology at the Tan Tock Seng Hospital in Singapore will oversee and manage the project with the assistance of Ms Mable Yap, Manager of the Institute’s Training Operations team.

Dr Chow has prior experience with organizing and conducting regional and international infectious disease outbreak management workshops (including the Outbreak Management Training programme for Vietnamese health officials in 2013 and international Outbreak Investigations and Management Course in 2014 mentioned above), and is familiar with the potential trainers for the programme. Ms Yap has organised many international workshops for the Institute and her team is well-versed with the operations support required for the smooth running of the proposed workshops.

Cost Efficiency

Not Applicable.

Drawdown Timetable

Not Applicable.

Direct Labour

Not Applicable.

Waivers

Not Applicable.

Are there any supporting document attached?

No 
Attachments
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Version HistoryVersion History

Project No.

Project Title

Project Status

Publication (if any)

Fund Account

Sub-fund

Project Year

Project Session

APEC Funding

Co-funding Amount

Total Project Value

Sponsoring Forum

Topics

Committee

Other Fora Involved

Other Non-APEC Stakeholders Involved

Proposing Economy(ies)

Co-Sponsoring Economies

Expected Start Date

Expected Completion Date

Project Proponent Name 1

Job Title 1

Organization 1

Postal Address 1

Telephone 1

Fax 1

Email 1

Project Proponent Name 2

Job Title 2

Organization 2

Postal Address 2

Telephone 2

Fax 2

Email 2

Declaration

Project Summary

Relevance

Objectives

Alignment

TILF/ASF Justification

Beneficiaries and Outputs

Dissemination

Gender

Work Plan

Risks

Monitoring and Evaluation

Linkages

Sustainability

Project Overseers

Cost Efficiency

Drawdown Timetable

Direct Labour

Waivers

Are there any supporting document attached?

hdFldAdmin

Project Number

Previous Fora

Secretariat Comments

Reprogramming Notes

Consolidated QAF

Endorsement By Fora

PD Sign Off

Batch

Forum Priority

Committee Ranking Category

Committee Priority

PDM Priority

Priority Within Funding Category

Monitoring Report Received

Completion Report Received

PMU Field 1

PMU Field 2

PMU Field 3

On Behalf Of

Proposal Status

Originating Sub-Forum

Approval Status
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