The “After Burn” of Lessons Learned in Hospital Administration

Simon Bragg – Executive Director of Finance and Resources, East Coast Community Healthcare 

Now back in the UK, reflecting on my recent participation in the GHLI Health and Social Care Strategic Leadership Programme at Yale – I am thoughtful of the takeaways from my experiences with both the mental – and physical – aspects of my visit. 
I could wax lyrical about the softer benefits of the programme; the contacts made, the relationships forged and the cathartic nature of shared experiences.  It can be incredibly reassuring to meet like-minded individuals battling similar issues elsewhere in the health system. There is nothing like applying raw theory to a practical situation to embed the learning – and from the presentations provided by the course participants it was evident that our class had taken away a great deal from the course – not only about each other, but more about themselves!
The UK and the US are rather languidly referred to as nations divided by a common language, which works on the level of two health care systems divided in their foundations but united by a common purpose and sharing common issues.  The excellent site visits to regional health care facilities demonstrated that although hospitals seem to face some of the same challenges in both countries, the patient experience is at the heart of everything that we do.  The systems appear to be as similar as they are disparate.

I was inspired by the demonstrable, and personally evidenced, the important link between physical health and mental wellbeing on my professional performance in a leadership role.  Early morning exercise sessions were arranged for course participants and both me and my rapidly tightening muscles were heartened to learn that my invigorated metabolism continues to burn calories for many hours after exercise itself has ceased.  Like the continued burning of calories following exercise – the GHLI programme promotes the survival of mental acuity by delivering both an immediate intellectual perspective as well as a slower burn of on-going inquisitiveness; in short a full-on cerebral workout.

Foreign Affairs in Ethiopia and U.S. – Different yet Similar

Mekonnen Haddis, Chief Advisor of the Minister, Ethiopia 
As I sat and listened to U.S. public servants discuss problems they have faced regarding employee retention and recruitment for the government, I was surprised, yet somehow comforted to realize that Ethiopia and the U.S. face similar challenges. 
Our Ethiopian delegation was so pleased to be invited to Yale University by the Global Health Leadership Institute for the Strategic Thinking in Foreign Affairs Symposium. During our visit, my Ministry of Foreign Affairs colleagues and I heard from leading practitioners and U.S. public servants who were candid in sharing their views and knowledge with us on a range of issues. Their insight helped us to develop better strategic plans on our own foreign policy, organizational capacity and leadership, which will prove invaluable when we return home.
During our week on the Yale campus, some of the work I most appreciated involved our Yale colleagues sitting down with us to solve problems we had identified within our government system. Through discussion and exercises with some of United States’ leading grand strategy thinkers, we learned to put theory and practice together to address critical problems.

We left New Haven to spend a week in Washington, D.C., visiting the State Department and government representatives. What impressed us most in DC was the priority that the U.S. officials gave us, ensuring they spent time with us in spite of their work load to help us in our endeavors to transform our ministry and country. The level of respect we received at the Department of State and all other places was exceptional. As this was the first visit to D.C for many of us, we were also anxious to see the landmarks about which we had heard so much. The Foreign Service Institute was much bigger than we had expected, and The White House, Capitol and Lincoln Memorial visits were unforgettable. 

After our impressive visit to the U.S., we confidently take home guidance and experiences to embark on a strategic mission to implement our foreign policy both with vigor and commitment.

Yale Women: Health Innovation and Entrepreneurship

Seth Nigrosh

As an international relations major at Connecticut college, classes that relate to public health and global health were not on my radar for a long time. I have recently become interested in the subject, and realized that as senior year was coming to a close, I had few ideas about what a job in the global health industry would look like. When I had the opportunity to attend Yale’s “Women in Innovation: Leading Yale Women in Social and Healthcare Startups” panel discussion I was eager to go. All three panelists, Barbara Bush, YC ’04, founder of Global Health Corps; Jennifer Staple-Clark, YC ‘03, founder of Unite for Sight; and Laura Niklason PhD, MD Yale faculty and co-founder of Humacyte explained origin of their respective organizations and how they ended up at the forefront of the global health community.
I was curious to hear how people who do not have any sort of health or medical background can still be involved in a global health project. When Ms. Bush spoke about her time at Yale as an architect student and Ms. Staples-Clark talked about the importance of removing barriers to care, I realized that global health is an inherently interdisciplinary undertaking. Scientific work by people like Professor Niklason, whose research into regenerative tissue and arterial implants is breaking new ground, will always be needed. But, we also need people who are experts in logistics who can get new medicines and technologies around the globe, and advocates to keep up pressure on public figures to respond to global health crises. I used to ask myself, “Should I have majored in IR? I love it, but I don’t want any of those traditional government or finance jobs!” Now, I see that instead I should be asking myself, “How can I take what I’ve learned and apply it to a complex and intriguing field like global health?” In today’s interconnected world, it’s not just what you know, but how you apply it creatively, that matters.

GHLI Hosts U.K. Visitors for Training Conference

In July the Global Health Leadership Institute hosted the International Health and Social Care Leadership Programme, a partnership between GHLI and the South Essex Partnership University NHS Foundation Trust (SEPT).  SEPT provides health care services to U.K. communities and has a partnership with GHLI to strengthen the capacity of health and social care leaders.  The 18 delegates worked with GHLI on  field assignments tackling public health issues, and presented their final assignments at the conference.  Delegates also heard lectures from Yale faculty and visited health care facilities in and around New Haven.

GHLI faculty director, Elizabeth Bradley, Ph.D., provided a history on health care systems in the U.S. including community health care centers and health maintenance organizations.  Dr. Bradley highlighted the physician-led Geisinger Health System in Pennsylvania as a model of high quality integrated health care services.  She ended her presentation with a charge to delegates to continue brainstorming ways in which health care systems can be improved.

Site visits to health care facilities are a key part of this program.  Delegates visited the Smilow Cancer Hospital, Yale-New Haven Psychiatric Hospital, Connecticut Valley Hospital and the Cornell Scott Hill-Health Center.  Following the site visits, delegates shared their experiences.  They were impressed by the investment several of the facilities made in their employees, from their interview stage to ongoing reinforcement for employees throughout their careers.  “We struggle to get staff feedback and retain employees for any length of time,” said one delegate.  “The investment in employees we observed set up a strong system for employee engagement and long-term retention and that is something we can do better.”  Delegates also noted that the U.K. seemed to be better at long-term follow-up with patients after they left a hospital.  This type of follow-up helps them rate the quality of care, which is something they felt could be improved in U.S. hospitals.

The SEPT delegates said they felt re-energized to tackle challenges they face as health care leaders and plan to continue working together.

Yale Hosts 2013 Global Health Corps Training

GHLI executive director Michael Skonieczny and GHC co-founder Barbara Bush

For the third year in a row, the latest class of Global Health Corps (GHC) fellows came to Yale University for a two-week training program preparing them for year-long placements with health organizations around the globe. The GHC was co-founded by Barbara Bush (Yale ’04) and provides fellowships for young professionals who tackle health issues across the globe. This year’s class of 106 fellows hails from 16 countries, and will serve with 44 health organizations in in Burundi, Malawi, Rwanda, Uganda, Zambia, and select cities in the U.S. During the two week training, GHC fellows had the opportunity to hear presentations from global health leaders, participate in group discussions and attend professional development workshops.

During the training, the fellows listened to Yale lecturer Mark Schoofs, a Pulitzer Prize winning journalist and senior editor at ProPublica. In his talk, “Journalism and Global Health: How to Make Your Voice Heard,” Schoofs discussed the relationship between journalists and activists and explained how journalism can help spread important global health messages. He relayed his own experience reporting on AIDS in Africa and noted the power investigative journalism can have in the field of global health. Schoofs encouraged GHC fellows to, “find ways in which you can advocate for resources to supplement health systems and global health programs.”

In Barbara Bush’s introduction of GHLI executive director, Michael Skonieczny, she thanked him and the GHLI for providing a home for the GHC training and the GHLI’s ongoing partnership and support of their efforts. The fellows were welcomed by Mike and heard a presentation on leadership from GHLI faculty director Elizabeth Bradley, Ph D.  Bradley explained how leadership is “the process of engaging others to achieve group objectives,” and encouraged GHC fellows to think about the relationship between the leadership role and the followership role, and how they complement each other. GHLI hopes to continue working closely with GHC as a partner in the fight for global health equity.   

Yale GHLI Conference Welcomes Delegates from Around the Globe

Rosalind D’Eugenio,
GHLI Director of Communications
Brazil, the Eastern Caribbean and Uganda joined Ghana this year at the 5th Yale GHLI Conference. More than 25 delegates came to Yale’s campus for a week to share experiences and create strategies for priority health issues in their countries.
The Eastern Caribbean and Uganda will focus on non-communicable diseases (NCDs), like diabetes, that are rapidly adding to the mortality rates of those regions. In Uganda, patients with chronic NCDs do not receive proper care in the government health sector. During the Conference, Ugandan delegates will seek to find ways to build capacity in clinical care, health worker training and research to help provide effective and integrated care for patients with NCDs. Similarly the Eastern Caribbean delegation will look to the collection and integration of data and evidence into planning for strengthened primary health care to address NCDs.
Brazil comes to Yale with a focus on early childhood development. The delegates would like to leave this week with a strategy to implement for self-sustaining and replicable programs to provide quality early childhood care and education services to improve health and reduce violence.
Ghana returns with a continued focus on mental health issues, but noted many improvements in this area since they attended the GHLI Conference in 2011. Dr. Angela Ofori-Atta noted several changes in Ghana’s mental health system based on the partnership developed between Yale, the South Essex Partnership Trust in the UK and the delegation, including passage of landmark mental health legislation and the creation of five year mental health plan. They still face delays in implementing the new law and inadequate human resources and funding, but hope to come away with a plan to address these hurdles when they return to Ghana.
In one of his final appearances as President of Yale, Richard Levin addressed the crowd to thank them for partnering with Yale in taking on such important global health problems. “Together we can make a difference in the health of all individuals across countries,” said Levin.

Why We Do What We Do: Angela Ofori-Atta

Angela Ofori-Atta, Ph.D., clinical psychologist at the University of Ghana Medical School, was the only African in her graduate school class at the University of British Columbia. During her studies, many discussions focused on North America and health challenges– piquing her interest in the field of mental health. Angela was encouraged when she found that, although expressed differently based on culture, the theories she was studying were applicable to her home country, Ghana. After reading “Behavior Therapy” by Wolpe, Angela became fascinated by the science of behavior and her focus began to shift to how the language of health transcended borders.

“I first heard of a global health conference at Yale through my husband, a Yale alumni and I was eager to be a part of our country’s delegation,” explains Angela. “The GHLI Conference seemed like a great opportunity to share ideas and strategies on how to address Ghana’s health issues with colleagues at Yale and with other countries.”

Angela’s work examines poverty’s impact on mental health. Although she has seen great strides in this area – including the passing of the mental health bill in 2012, Act 846 – she believes there is still much work to be done.  Mental health is often given the least priority in countries where contagious diseases are an issue.

In Ghana, although we are still without certain essential disciplines such as psychotherapists and occupational therapists, the mental health workforce now includes more individuals who are passionate about their work and focused on the patient. “Stigmatism around the field is changing and people are practicing more ethically,” said Angela. Collaboration between mental health workers and academia has aided in these positive shifts but lack of financial resources is a constant challenge.

When asked her advice for those looking to enter the field, Angela said, “Be prepared to believe in what you do.” Her belief and passion for the field of mental health has inspired others to face challenges and believe in the potential for progress.

Bridget Bash, GHLI Staff